What are the three factors that influence pricing?
1. List and discuss the three payment-determination bases.
2. Explain the difference between a “specific services” payment unit compared to a “bundled services” payment unit.
3. What are the three major ways that health care providers can control their revenue function?
4. What are the three factors that influence pricing?
5. Why does market share matter to a health care provider?
GENERAL PRINCIPLES OF ACCOUNTING
Short Answer (10 points each)
1. Explain the difference between the accrual basis of accounting and the cash basis of accounting.
2. What are the major reasons for accrual accounting?
3. How are revenues and expenses defined under accrual accounting?
4. What is an audit (in the context of financial accounting)?
5. What are the double-entry accounting system and the duality concept? How are they related?
Cleverley, W. O. (2011). Essentials of Health Care Finance, (7th Edn). Sudbury, MA: Jones & Bartlett Learning.
LEARNING OBJECTIVE 1
Describe the basic methods of payment for healthcare firms.
PAYMENT METHODS AND THEIR RELATIONSHIP TO PRICE SETTING
In Chapter 3 we discussed four generic methods of payment for healthcare firms: historical cost, bundled services, billed charges, and capitated rates. Table 6–1 presents a scheme for categorizing payment plans by two dimensions:
• 1. Payment basis
• 2. Unit of payment
The payment basis describes the manner by which a payer (Medicare, Medicaid, Commercial Health Plans, and others) determines the amount to be paid for a specific healthcare claim. There are three payment bases: cost, fee schedule, and price related.
Table 6-1 Healthcare Payment Methods
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