11/5/24, 3:52 AM HMP 320 Final Flashcards | Quizlet
HMP 320 FinalWITH COMPLETE SOLUTIONS GRADED
A+.
helps Americans know the price of their service
but the charges aren't really transparent because your insurance does it for you
Hospital price transparency helps define the value of those services and enables patients and other care
purchasers to identify, compare, and choose providers that offer the desired level of
value
requires health systems to publicly post the cost of their items and services online
severity of patients illness
quality of care
intensity of services
Why do some hospitals cost more than
cost shifting to pay for research and teaching
others?
differences in billing
prices of labor and other inputs
Efficiency
Does it make a difference to hospitals that
95 percent of their funds come from third-
party insurance rather than patients?
How do hospitals get paid?
Who owns a not-for-profit hospital? Who
gets the excess revenues?
hospitals are merging to engage in financial arbitrage and gather leverage that can
Private equity
be used to bargain against suppliers, payers, and patients
increased the number of hospitals by congress providing money for building them
----> any hospital that received money from gov. had to provide free/low cost care
Hill-Burton Act to the poor
the result: more hospitals and hospital beds
https://quizlet.com/697294924/hmp-320-final-flash-cards/ 1/12
, 11/5/24, 3:52 AM HMP 320 Final Flashcards | Quizlet
"a built bed is a filled bed"
Roemer's Law
there were incentives to fill the bed
A state-directed program that requires healthcare facilities to submit detailed plans
and justifications for the purchase of new equipment, new buildings, or new service
Certificate of Need offerings that cost in excess of a certain amount
-likely led by Roemer's Law
Technology advances have reduced recovery times
increased outpatient visit and decreased length of stay
Trends with hospitals as technology (Lanar- charges outpatient, but is really inpatient)
increased
number of outpatient visits has increased throughout the years and length of stay has
shorted
Grants
global budgets
charges
per diem
Sources of Revenues/Reimbursement
cost reimbursement
DRGs (Diagnoses related groups)
Capitation
Managed care contracts
funs donated for a specific purpose: cancer research, new operating building,
outreach program
Grants in hospitals tax appropriations are a form of a grant (donor is the government)---> creates tax
break from hospitals
Ex: Cancer Sylvester Center
fixed budgets provided to the hospital from revenues
Global Budget in hospitals
provided regardless of number of patients treated
known as "list prices"
because hospitals are INELASTIC, they can set their price to whatever they want
Charges in hospitals Medicaid and Medicare set up charges for hospitals
private insurers negotiate chargers for populations
uninsured patients- pay full price
document that contains a computer-generated list of procedures, services, and
supplies with charges for each;
Chargemaster
Data is entered in the facility's patient accounting system, and charges are
automatically posted to the patient's bill
https://quizlet.com/697294924/hmp-320-final-flash-cards/ 2/12
HMP 320 FinalWITH COMPLETE SOLUTIONS GRADED
A+.
helps Americans know the price of their service
but the charges aren't really transparent because your insurance does it for you
Hospital price transparency helps define the value of those services and enables patients and other care
purchasers to identify, compare, and choose providers that offer the desired level of
value
requires health systems to publicly post the cost of their items and services online
severity of patients illness
quality of care
intensity of services
Why do some hospitals cost more than
cost shifting to pay for research and teaching
others?
differences in billing
prices of labor and other inputs
Efficiency
Does it make a difference to hospitals that
95 percent of their funds come from third-
party insurance rather than patients?
How do hospitals get paid?
Who owns a not-for-profit hospital? Who
gets the excess revenues?
hospitals are merging to engage in financial arbitrage and gather leverage that can
Private equity
be used to bargain against suppliers, payers, and patients
increased the number of hospitals by congress providing money for building them
----> any hospital that received money from gov. had to provide free/low cost care
Hill-Burton Act to the poor
the result: more hospitals and hospital beds
https://quizlet.com/697294924/hmp-320-final-flash-cards/ 1/12
, 11/5/24, 3:52 AM HMP 320 Final Flashcards | Quizlet
"a built bed is a filled bed"
Roemer's Law
there were incentives to fill the bed
A state-directed program that requires healthcare facilities to submit detailed plans
and justifications for the purchase of new equipment, new buildings, or new service
Certificate of Need offerings that cost in excess of a certain amount
-likely led by Roemer's Law
Technology advances have reduced recovery times
increased outpatient visit and decreased length of stay
Trends with hospitals as technology (Lanar- charges outpatient, but is really inpatient)
increased
number of outpatient visits has increased throughout the years and length of stay has
shorted
Grants
global budgets
charges
per diem
Sources of Revenues/Reimbursement
cost reimbursement
DRGs (Diagnoses related groups)
Capitation
Managed care contracts
funs donated for a specific purpose: cancer research, new operating building,
outreach program
Grants in hospitals tax appropriations are a form of a grant (donor is the government)---> creates tax
break from hospitals
Ex: Cancer Sylvester Center
fixed budgets provided to the hospital from revenues
Global Budget in hospitals
provided regardless of number of patients treated
known as "list prices"
because hospitals are INELASTIC, they can set their price to whatever they want
Charges in hospitals Medicaid and Medicare set up charges for hospitals
private insurers negotiate chargers for populations
uninsured patients- pay full price
document that contains a computer-generated list of procedures, services, and
supplies with charges for each;
Chargemaster
Data is entered in the facility's patient accounting system, and charges are
automatically posted to the patient's bill
https://quizlet.com/697294924/hmp-320-final-flash-cards/ 2/12
