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A retrospective bundle initially pays each provider for services in the traditional fee-for-service payment method; after the completion of the episode of care, a provider designated as the accountable provider for the bundle receives a share of savings relative to the bundle price or pays a share of costs in excess of the bundle price.
A prospective payment system (PPS) is a term used to refer to several payment methodologies for which means of determining insurance reimbursement is based on a predetermined payment regardless of the intensity of the actual service provided. It includes a system for paying hospitals based on predetermined prices, from Medicare.
In summary, the Medicare "Prospective" Payment System has multiple retrospective factors that limited cost sharing in 1990. McClellan's review serves as a harbinger of current attempts to model a health care reimbursement program focused on pay for performance criteria such as penalties for readmissions and incentives for value-based purchasing.
Digital River to Acquire LML Payment Systems MINNEAPOLIS & VANCOUVER, British Columbia--(BUSINESS WIRE)-- Digital River, Inc. (NASDAQ: DRIV), the revenue growth experts in global cloud commerce ...
LML Payment Systems Inc., through its Canadian subsidiary Beanstream Internet Commerce Inc., and US subsidiaries Beanstream Internet Commerce Corp and LML Payment Systems Corp., is a leading ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
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