Question

Problem 5 Which statement is FALSE about the methods of hospital payment? A. In per diem, the insurer is at not risk for the number of services B. In the past, insurance companies made fee-for-service payments to C. With capitation payment, hospitals are at risk for admissions, the D. With DGR, Medicare is at risk with the number of admissions performed on any given day private hospitals based on the principle of "reasonable cost." length of stay, and the resources used. E. In capitation, the hospital receives one payment for all the services provided in one year, and the hospital is entirely at risk Problem 6 Which statement is FALSE about the Conclusion section of the chapter? A. Private insurers, Medicare, and Medicaid are replacing fee-for service payment with more aggregated payment mechanisms to shift rishk B. Payment levels are increasingly determined by negotiation between C. Payers are trying to find the right balance between economic D. Many people believe that the ACO payment model is an intermediate E. The US HHSS has the goal that 90% of Medicare payments occurring away from payers towards physicians and hospitals payers and providers or by fee schedules set by payers incentives for overtreatment and undertreatment. state on the way to true global capitation through bundled payments and ACO models by 2018 Problem 7 Which statement is FALSE about thetraditional British National Health Service (NHS)? A. The primary care level is virtually the exclusive domain of B. Physicians located at hospital-based clinics compose the secondary C. Tertiary care subspecialists are located at a few tertiary care specialist tier of healthcare. medical centers D. Except in emergency situations, all patients are first seen by a GP. E. Some other nations have adopted a similar approach to organizing health services

Answer 1

Solution-
6. Payers are trying to find the right balance between economic incentives for overtreatment and under treatment.

Reason: Rather than payers, insurance companies are trying to make balance between economic incentives for over & under treatment.

5.With DGR, Medicare is at risk with the number of admissions

In DGR (Diagnosis related group), Medicare pays hospital at flat rate and thus doesn't matter for number of adminissions