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Related Flashcards
Cards In This Set
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What are professional standards review organizations (PSROs)?
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to review the quality, quantity, and cost of hospital care
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What are utilization review (UR) committees?
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to review the admissions, diagnostic testing, and treatments provided by physicians who cared for clients receiving Medicare
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What is the prospective payment system(PPS)?
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eliminated cost-based reimbursement
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What are diagnosis-related groups (DRGs)?
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Each group had a fixed reimbursement amount with adjustments based on case severity, rural/urban/regional costs, and teaching costs.
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What is capitaion?
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means the providers received a fixed amount per client or enrollee of a health care plan
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What is managed care?
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describes health care systems in which there is administrative control over primary health care services for a defined population
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