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Healthcare finances reimbursement

I would like pros and cons of the following reimburesments:

Prospective-payment, Cost-reimbursement, Discounted-charge, Flat-rate reimbursement.

How does each of the reimbursement system affect the departments of health care companies and healthcare providers.

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Prospective payment systems establish payment rates in advance. These rates are determined by basing averages of resources used. The prospective payment system can result in more coordination and collaboration among all the health care provider team. The prospective payment system formulas are complex and difficult to understand. The inpatient prospective payment system under Medicare is know as DRG. The efficient providers will profit and the inefficient will not. The prospective payment system has no focus on quality of care and patient safety, the focus is on economic efficiency.

Cost re-reimbursement covers self-reported provider costs and service usage. The costs are not validated and this can encourage more care and less efficiency. This method can generate more costs and places most risk on the payer or insurance company. The provider has little or ...

Solution Summary

Healthcare finances reimbursements are examined. The prospective-payment, cost reimbursement, discounted-charge and flat-rate reimbursement is examined.