prospective payment

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Related to prospective payment: capitation


remuneration in exchange for goods or services.
prospective payment payment to a health care facility at a predetermined rate for treatment regardless of the cost of care for a specific individual patient.
third party payment payment of hospital or other health care bills by a source other than the patient; the most common sources are private or governmental insurance. Called also third party reimbursement.

pro·spec·tive pay·ment

(prŏs-pek'tiv pā'mĕnt)
Reimbursement for services made in advance or without services having yet been performed.
References in periodicals archive ?
The Medicare system introduced prospective payment in 1984, and many studies have explored the consequences of its adoption.
The Skilled Nursing Facility Prospective Payment System, implemented in 1998, shifted payment from a cost-based system with limits for routine operating costs to a per diem payment based on a patient's "resource use group" (RUG) defined by the types and amount of medical services required (e.
The author reviews the origins of the prospective payment legislation and then describes the methods used to calculate prospective payments.
One possibility would be that when prospective payment was implemented there would be no case-mix increase among Medicaid patients.
The next important acronym in health care may be AVGs (Ambulatory Visit Groups), a prospective payment system for outpatient care.
Between 1997 and 2002, Medicare introduced an interim payment system for HHAs (1997) and prospective payment for SNFs (1998), HHAs (2000), and IRFs (2002).
Including Medicare, with prospective payment of both inpatient and outpatient services, would, once and for all, settle the long-standing argument between proponents of the single-payer versus competitive approaches to health care cost containment.
Often, these workshops have ominous titles like "Dealing with the revolution in health care," or "How to survive under a prospective payment system.
IEHP intends to release a Request for Proposal for prospective payment software or services.
The single most significant event in the last five years that has influenced how rehab is delivered and reimbursed is the Medicare prospective payment system (PPS).

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