2022-10-26T23:02:20+03:00[Europe/Moscow] en true <p>&lt;30 days</p>, <p>&gt;30 days</p>, <p>General hospital</p>, <p>Specialty hospitals</p>, <p>For-profit</p>, <p>Non-profit</p>, <p>Community Hospitals</p>, <p>teaching hospital</p>, <p>Multi-hospital system</p>, <p>Retrospective Payment System (RPS)</p>, <p>Patient mix</p>, <p>Cost</p>, <p>wage index application, teaching status, disproportionate share payments, severity </p>, <p>Balanced Budget Act (BBA)</p>, <p>decrease in no. of inpatient admissions and shortened LOS, increase in post-hospital use of services like NH, unbundled services, reclassification of patients in higher weighted DRGs, shift severely ill patients to other institutions </p>, <p>Diagnosis-related groups (DRGs)</p> flashcards
Hospital Paying mechanisms & Hospital types

Hospital Paying mechanisms & Hospital types

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  • <30 days

    How long is the length of stay for acute care hospitals?

  • >30 days

    How long is the length of stay for long-term hospitals?

  • General hospital

    -provide a variety of services including general medical and surgical services, obstetric services, etc.

  • Specialty hospitals

    -concentrate on one disease like psychiatric diseases, cancer, or tubuerculosis, or one segment of the population such as children or veterans.

  • For-profit

    have to distribute some of their profits to investors

  • Non-profit

    have no investors that they must pay dividends to; get to enjoy the income and property tax exemptions

  • Community Hospitals

    -all nonfederal, short-term general or specialty hospitals

    -can be teaching hospitals as well; must be nonfederal tho

  • teaching hospital

    -may be expressly associated with a medical school or have an affiliation

    -must offer physician training in order to be considered this

  • Multi-hospital system

    -when a hospital is either leased under contract by another hospital or are legally incorporated by or under the direction of a board that determines the control of 2 or more hospitals

    -ex: baptist

  • Retrospective Payment System (RPS)

    -reimbursement on the basis of cost or charges

    -this causes hospitals to: perform more procedures, increase LOS for patients, reduce efficiency in hospital management

  • Patient mix

    -accounts for loss due to non-paying patients or less payments made by insurers than actual cost

  • Cost

    -the price that is negotiated between the hospital and third-party payers. (cost < charges)

    -usually ends up being less

  • wage index application, teaching status, disproportionate share payments, severity

    factors that influence reimbursement amount

  • Balanced Budget Act (BBA)

    -introduced prospective payment systems

    -reduced medicare reimbursements by $115 billion

  • decrease in no. of inpatient admissions and shortened LOS, increase in post-hospital use of services like NH, unbundled services, reclassification of patients in higher weighted DRGs, shift severely ill patients to other institutions

    What are the 5 biggest impacts of PPS?

  • Diagnosis-related groups (DRGs)

    -places patients into groups based on their diagnosis; each with an assigned weight

    -depends on condition, severity, comorbidities

    -this is all based on the average resources used to treat medicare patients in that treatment group