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  2. Medicare Access and CHIP Reauthorization Act of 2015

    en.wikipedia.org/wiki/Medicare_Access_and_CHIP...

    Signed into law by President Barack Obama on April 16, 2015. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub. L. 114–10 (text) (PDF)) commonly called the Permanent Doc Fix, is a United States statute. Revising the Balanced Budget Act of 1997, the Bipartisan Act was the largest scale change to the American health ...

  3. Fee-for-service - Wikipedia

    en.wikipedia.org/wiki/Fee-for-service

    Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health care quality is ...

  4. Ambulatory Payment Classification - Wikipedia

    en.wikipedia.org/wiki/Ambulatory_Payment...

    APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...

  5. Prospective payment system - Wikipedia

    en.wikipedia.org/wiki/Prospective_payment_system

    Prospective payment system. 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 ...

  6. Pay for performance (healthcare) - Wikipedia

    en.wikipedia.org/wiki/Pay_for_performance...

    Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]

  7. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    Medicare (United States) Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It was begun in 1965 under the Social Security Administration and is now ...

  8. Healthcare payment - Wikipedia

    en.wikipedia.org/wiki/Healthcare_payment

    Capitation is a payment arrangement for health care service providers. It pays a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care. The amount of remuneration is based on the average expected health care use of that patient, with payment for patients generally varying by age and ...

  9. Diagnosis-related group - Wikipedia

    en.wikipedia.org/wiki/Diagnosis-related_group

    Diagnosis-related group. Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, [1] with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management ...

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