Price
Payment Models under Value-based payment programs
Establishing the Price
Pricing Objectives
Miscellaneous
100

This is the level of monetary reimbursement a firm demands for its goods or services.

What is Price?

100

This is the model where physicians can receive bonuses for meeting quality and financial goals.

What is Pay for performance?

100

This is the major factor in establishing price is recognizing THIS for the product/service.

What is Demand?


100

Companies use this strategy by setting a high initial price.

What is skimming price?

100

This is the point of volume where total revenue equals total costs.

What is Break-Even Point?


200
This is the full set of prices set by every hospital for every service.

What is chargemaster?

200

This is the payment where providers receive a fixed amount to perform all the services for a specific procedure.

What are bundled payments?

200

This is the period of time for a product/service that may change over time due to the competitive market.

What is the Life Cycle?


200

This strategy is used to penetrate the market and gain sales.

What is penetration pricing strategy or pricing the product at a low price?

200

This is based on the concept that the price per additional procedure must equal or exceed the cost of an additional procedure.

What is marginal cost pricing?

300

This is what the payer agrees to pay the service provider for the costs incurred in providing services to a population.

What is cost-based reimbursement?

300

This is where providers decide what is best to spend on all the population under their care.

What is capitation?

300

This is an application that must justify that a demand exists and additional capacity is needed.

What is Certificate of Need?

300
This is a strategy used when a high price is established relative to the competition.

What is prestige pricing?

300

This involves calculating the per unit cost of producing the service and determining the markup %'s needed to cover the cost of selling and the profit.

What is Markup Pricing?

400

This is the payment made for services that are delivered.

What is fee for service?

400

This is where providers set a budget for care delivery; if they can provide care < the budget amount, they share in the savings.

What is shared savings?


400

This is when one seller sets the price for a unique service.

What is a monopoly?

400
You want to gain as much of this as possible when establishing the price for a new service or product.

What is Market Share?

400

This is whereby items are priced at just below whole-dollar amounts.

What is Odd Pricing?

500

This is the payment mechanism that is used by the US Dept of HHS for inpatient admissions.

What are diagnostic related groups (DRG's)?


500

This is where providers share in any savings, but are responsible for the costs beyond the budget.

What is shared risk?


500

Market structure in which a few companies control a majority of industry sales.

What is Oligopoly?


500

These are price reductions provided when the product is purchased out of season.

What are Seasonal Discounts?