Payment Systems
Under the Inpatient Prospective Payment System (IPPS), hospitals are paid based on this unit
What is the Diagnosis-Related Group (DRG)?
This term describes when hospitals merge or acquire others to form larger systems.
What is consolidation?
This public program finances most long-term care services in the United States.
What is Medicaid?
The closure of rural hospitals often leads to reduced access to this type of essential care.
What is emergency or specialty care?
The main goal of shifting from cost-based reimbursement to prospective payment was to encourage this
What is efficiency (or cost control)?
True or False: Hospital consolidation typically leads to lower prices for patients.
What is False? (It usually increases prices.)
This type of care — often delivered at home — has expanded as a patient-centered and potentially cost-saving alternative to nursing homes.
What is home-based (or community-based) care?
Policies that emphasize efficiency can sometimes harm low-income populations by reducing this.
What is access to care (or service availability)?
This is one potential downside of the Prospective Payment System, where hospitals might discharge patients too soon to save money.
What is premature discharge (or reduced quality of care)?
This type of policy — used by the FTC and DOJ — seeks to prevent hospital mergers that reduce competition and raise prices.
What is antitrust enforcement?
Long-term care facilities often face financial strain because Medicaid reimbursement rates are set this way.
What is below the actual cost of care?
Nonprofit hospitals often face an ethical dilemma in balancing their charitable missions with this financial reality.
What is the need to remain profitable (or maintain financial stability)?