The Prospective Payment System (PPS) Is Based on the Concept

question 27

Multiple Choice

The prospective payment system (PPS) is based on the concept that:

• A) reimbursement to hospitals is not a major problem.
• B) similar medical diagnoses result in the same hospitalization costs.
• C) standards of practice can be set.
• D) total patient care can be delivered in a safe and holistic manner.

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Definitions:

Health Maintenance Organizations

Organizations that provide or arrange managed care for health insurance, self-funded health care benefit plans, individuals, and other entities.

Private Health Carriers

Organizations that provide private health insurance coverage to individuals, offering various healthcare benefits and plans.

Blue Cross And Blue Shield

A federation of U.S. health insurance organizations providing coverage for individuals across various states, known for offering health insurance plans including medical, pharmaceutical, and dental services.

Education For Physicians

Specialized training and ongoing learning that doctors undergo to maintain their medical knowledge and skills.