Problem 5 Which statement is FALSE about the methods of hospital payment? A. In per diem,...

 

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Problem 5 Which statement is FALSE about the methods of hospital payment? A. In per diem, the insurer is at not risk for the number of services performed on any given day. B. In the past, insurance companies made fee-for-service payments to private hospitals based on the principle of "reasonable cost." C. With capitation payment, hospitals are at risk for admissions, the length of stay, and the resources used. D. With DGR, Medicare is at risk with the number of admissions.. E. In capitation, the hospital receives one payment for all the services provided in one year, and the hospital is entirely at risk. Problem 6 Which statement is FALSE about the Conclusion section of the chapter? A. Private insurers, Medicare, and Medicaid are replacing fee-for- service payment with more aggregated payment mechanisms to shift risk away from payers towards physicians and hospitals. B. Payment levels are increasingly determined by negotiation between payers and providers or by fee schedules set by payers. C. Payers are trying to find the right balance between economic incentives for overtreatment and undertreatment. D. Many people believe that the ACO payment model is an intermediate state on the way to true global capitation. E. The US HHSS has the goal that 90% of Medicare payments occurring through bundled payments and ACO models by 2018. Problem 7 Which statement is FALSE about the traditional British National Health Service (NHS) ? A. The primary care level is virtually the exclusive domain of specialist. B. Physicians located at hospital-based clinics compose the secondary tier of healthcare. C. Tertiary care subspecialists are located at a few tertiary care medical centers. D. Except in emergency situations, all patients are first seen by a GP. E. Some other nations have adopted a similar approach to organizing health services. Problem 5 Which statement is FALSE about the methods of hospital payment? A. In per diem, the insurer is at not risk for the number of services performed on any given day. B. In the past, insurance companies made fee-for-service payments to private hospitals based on the principle of "reasonable cost." C. With capitation payment, hospitals are at risk for admissions, the length of stay, and the resources used. D. With DGR, Medicare is at risk with the number of admissions.. E. In capitation, the hospital receives one payment for all the services provided in one year, and the hospital is entirely at risk. Problem 6 Which statement is FALSE about the Conclusion section of the chapter? A. Private insurers, Medicare, and Medicaid are replacing fee-for- service payment with more aggregated payment mechanisms to shift risk away from payers towards physicians and hospitals. B. Payment levels are increasingly determined by negotiation between payers and providers or by fee schedules set by payers. C. Payers are trying to find the right balance between economic incentives for overtreatment and undertreatment. D. Many people believe that the ACO payment model is an intermediate state on the way to true global capitation. E. The US HHSS has the goal that 90% of Medicare payments occurring through bundled payments and ACO models by 2018. Problem 7 Which statement is FALSE about the traditional British National Health Service (NHS) ? A. The primary care level is virtually the exclusive domain of specialist. B. Physicians located at hospital-based clinics compose the secondary tier of healthcare. C. Tertiary care subspecialists are located at a few tertiary care medical centers. D. Except in emergency situations, all patients are first seen by a GP. E. Some other nations have adopted a similar approach to organizing health services.

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