prospective reimbursement

prospective reimbursement

a method of payment to an agency for health care services to be delivered that is based on predictions of what the agency's costs will be for the coming year.
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The program provides prospective reimbursement to living donors based on the estimated travel expenses related to the donation process.
Because the prospective reimbursement mandated for Medicare SNFs by that legislation reduced the industry's demand for therapists and, absent a commensurate reduction in supply, the "price of" (i.
A facility would spend a dollar to receive the same dollar back through the calculation of a future rate (Medicaid prospective reimbursement method) or receive a budgeted interim dollar which was adjusted in settlement at a later date (Medicare retrospective reimbursement method).
Reclassification allows a hospital to utilize its standardized operating cost or wage index, or both, of a neighboring region of higher than the prevailing rate in its own geographic area, to calculate its prospective reimbursement.
Prospective reimbursement systems allow greater control of increase in rate levels, as they did in prior analysis (Swan, Harrington, and Grant, 1988).
A transplant center with a disproportionate share of high risk patients has the potential of incurring higher programmatic costs than is covered by unadjusted prospective reimbursement approaches.
Also, Medicare has proposed a prospective reimbursement system for nursing homes to begin next year.
Ting: HCFA may develop special regulations for subacute care to accompany its prospective reimbursement.
These are most often categorized as retrospective, cost-based, flat-rate, or prospective reimbursement systems.
Maine's prospective reimbursement system contains both implicit and explicit incentives for nursing homes to contain costs.
Effects of Prospective Reimbursement Programs on Hospital Revenue, Expense and Financial Status.
This article defines homogenous peer groups of Department of Veterans Affairs providers for the purpose of establishing competitive prospective reimbursement rates.

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