HI 215 Purdue University Global Payment and

Reimbursement Process Case Study

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HI 215 Purdue University Global Payment and Reimbursement Process

Case Study

Instructions

1. Case Study: Case Study 7: Transfer Case. Write a 2–3 paragraph

response discussing what would you recommend that the New York State
Department of Health do to address the payment issue with transfer
cases? List at least three recommendations along with your rationale.

2. Refer to your reading from the PG Library this unit (Chapter

16: “Reimbursement Methodologies” (from the section headed “Healthcare
 Reimbursement Methodologies” to “Resource-Based Relative Value Scale
System”) and answer the following questions in one to two complete
sentences:

1. What type of payment system is in place when the amount of

payment is determined before the service is delivered?

2. Which utilization control is most closely associated with

managed fee-for-service reimbursement?

3. Describe the concept of capitation.

4. What were Medicare Part A payments to hospitals based on

prior to implementation of the diagnosis-related group PPS?

5. What type of diagnosis is the MS-DRG prospective payment

rate based on?

Assignment Requirements

 Please complete all parts in a Microsoft Word document.

 Quoting should be less than 10% of the entire paper. Paraphrasing is

necessary.

 You must cite and reference credible sources.

 Utilize the Academic Success Center in Academic Tools for

assistance with writing, APA style references, etc.