Paul Lang

A flat fee payment system instituted by the government to control the payment for outpatient services provided to Medicare recipients.

The method of payment in which the provider is paid a fixed amount for each person served no matter what the actual number or nature of services delivered over a set period of time, usually a month or a year.

A patient classification scheme used by Medicare that clusters patients into categories on the basis of patients' illnesses, diseases and medical problems.

What are discounts relative to the provision of healthcare?

How are Medicare and Medicaid financed?

A system to pay providers whereby the fees for all providers (i.e. hospitals, physicians, home health care agencies) are included in a single negotiated amount. This is sometimes called “bundling” of services.

A recent alternative payment arrangement that bases partial reimbursement and/or creates additional reimbursement incentives for providers based upon adherence to pre-defined standards for quality of care. Indicators include various patient outcomes and frequency and type of tests ordered and services performed.

Federal legislation designed to tighten accounting standards in financial reporting, and which holds top executives personally liable as to the accuracy and fairness of their financial statements.

Legislation enacted by CMS in 2005 to guard against providers’ ordering self-referrals for Medicare or Medicaid patients directly to any settings in which they have a vested financial interest. Also referred to as “anti-kickback” legislation.

List four (4) efforts attempted by providers to control costs.

comparing 2 organizations of materially different sizes

What % is one line item to another?

ability to meet short term obligations

financial viability of the organization

how efficient is organization using assets to produce revenue

how are assets financed, can organization take on new debt

measures efficiency of the organization’s assets to produce revenue

to what extent do fixed assets assist in the generation of revenue

indicates how old your equipment is – indicator of future capital investment needs

used by investment bankers and bond rating agencies-measures ability to meet total loan requirements (interest & principal)

demonstrates the ability to earn enough to pay interest expense requirements

reflects proportion of assets financed by equity

measures proportion of debt to net assets

measures how much profit per dollar invested in assets

measures rate of return on each dollar of owner’s assets or net assets

profits earned from primary business

% change in line item from one year to next. (subsequent yr-previous yr)/previous yr X 100

Can be used to view changes over several years (subsequent yr-base yr)/base yr X 100