GAPENSKIS FUNDAMENTALS OF HEALTHCARE
FINANCE EXAM 2026
◉ ○ Fee for service. Answer: incentive for volume, provides payment
each time a service is provided.
◉ § Per diem payment. Answer: fee for-service reimbursement
method that pays a set amount for each inpatient day
◉ § Bundled (global) payment. Answer: The fee for-service payment
of a single amount for the complete set of services required to treat a
single episo
◉ ○ Capitated. Answer: PMPM, incentive for quality: methodology
that is based on the number of covered lives as opposed to the
amount of services provided
◉ ○ Cost based reimbursement. Answer: reimbursement method
based on the costs incurred in providing ser
◉ ○ Charge based reimbursement. Answer: reimbursement A fee-
for-service reimbursement method based on charges (chargemas
, ◉ • Full cost pricing. Answer: Use cost to charges ratios to estimate
full costs, marginal costs, and profit to ensure prices are set to
recover FULL costs of services over the LONG RUN
◉ • Marginal cost pricing. Answer: Not a good strategy, but ok in the
SHORT TERM or for STRATEGIC REASONS because we can accept
prices that are lower than full cost as long as the revenue covers the
incremental or marginal costs so contribution margin is covered but
not everything
◉ • Target costing:. Answer: For price takers, the process of reducing
costs (if necessary) to the point where a profit is earned on the
market determined price
◉ • Cross subsidization. Answer: (price shifting) The pricing
approach wherein some payers are charged more than full costs to
make up for other payers that are paying less than fu
◉ • Price setter. Answer: A business that has the power to set the
market prices for its
◉ • Price Taker. Answer: A business that has no power to influence
the prices set by the marketplace (or by government