Câu 19: AHM-520: Health Plan Finance and Risk Management

The following statements are about various reimbursement arrangements that health plans have with hospitals. Select the answer choice containing the correct statement.

1. A. A sliding scale per-diem charges arrangement differs from a sliding scale discount on charges arrangement in that only a sliding scale per-diem charges arrangement is based on total volume of admissions and outpatient procedures.
2. B. Under a typical reimbursement arrangement that is based on diagnosis related groups (DRGs), if the payment amount is fixed on the basis of diagnosis, then any reduction in costs resulting from a reduction in days will go to the health plan rather than to the hospital.
3. C. A negotiated straight per-diem charge requires payment of a single charge for a day in the hospital, regardless of any actual charges or costs incurred during the hospital stay. — đáp án hiện tại
4. D. A straight discount on charges arrangement is the most common reimbursement method in markets with high levels of health plans.