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Healthcare payment system
Identify an aspect of the health care payment system.
Provide an overview of the criteria and parameters for implementation.
Identify the impact on nursing practice.
Example.
Outpatient, home health, physician and non-physician practitioner, and ambulatory surgical prospective payment systems differ significantly. The models used to perform prospective payments and the source and rate for each circumstance differ significantly. The Hospital Outpatient Prospective Payment System (OPPS) has a set of rules and regulations separate from the delivery of care in the acute setting. Some rules and regulations require different codes for billing. The Center for Medicare and Medicaid Services in the United States reimburses outpatient services using the OPPS.A system administered by Medicare that determines the amount of money a hospital or community center will receive for outpatient care to Medicare patients is known as the prospective payment system for outpatient care.
