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JM Ch. 29 + SLB Ch. 8 Crossword

Horizontales
Medicare Part B providers, including physical therapists and occupational therapists in private practice, can elect to accept or not accept the fee schedule amount as payment in full
A Medicare supplemental policy that beneficiaries can purchase to cover other expenses
Developed by the AHRQ on behalf of the USDHHS - 3 aims to improve quality of healthcare in the US: better care, healthy people and communities, & affordable care
Grades clinicians in 4 categories - quality, improvement activities, advancing care information, costs
Reimbursement for services is contingent at some level on processes and outcomes achieved by providers
"hope to produce better care at a lower cost by inducing changes in the way that clinicians and organizations deliver care"
Eligible persons have a guarantee to a defined set of benefits identified in the law
Used to report initial, anticipated discharge, and actual discharge functional status
Verticales
Systemic collection of health and health care-related data
A complex formula that examines factors associated with growth in the Medicare Part B program and attempts to adjust for this growth by limiting the overall costs of the Medicare Part B benefit
Medicare has phased out cost-based reimbursement in favor of various forms of _____________
Medicare Part B premium is paid to the managed care company, may offer benefits not provided in traditional Medicare
In 1983, the federal government initiated prospective payment for inpatient hospital stays by classifying patients into groups that could predict resource utilization
Financial limit on the responsibility of Medicare to pay for therapy services provided in private practice
Improving client experience of care, reducing per capita cost of healthcare, & improving the health of populations
List of procedures with associated payments
Also called episode-based payments, reimburse providers based on a full episode of care rather than for each individual service within an episode
Adds provider experience to Triple Aim
Works to improve healthcare in the US by reviewing and recommending performance measures
Used to identify best practices and quantify outcomes achieved by health care consumers