Free CCMC Healthcare reimbursement Questions and Answers
What is a Diagnosis-Related Group (DRG) in the context of healthcare reimbursement?
DRGs are used to classify hospital cases into groups that are expected to have similar hospital resource use, and they are a key component of the reimbursement process for hospitals.
Which of the following is a common reimbursement model used in healthcare?
Various reimbursement models exist, including capitation, retrospective cost-based reimbursement, and fee-for-service. Each model represents a different approach to paying for healthcare services.
Which of the following best describes the capitation payment model?
Under capitation, healthcare providers receive a set fee per patient per time period, which incentivizes cost control and efficient care management.
In a fee-for-service reimbursement model, how are healthcare providers compensated?
In a fee-for-service model, healthcare providers are compensated for each individual service or procedure they perform, encouraging quantity of care.
What is the purpose of value-based reimbursement in healthcare?
Value-based reimbursement models aim to improve healthcare quality and patient outcomes by linking payment to the effectiveness and efficiency of care, rather than the volume of services provided.