Which of the following is an episode-of-care reimbursement type?

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Study for the Certified Associate in Healthcare Information and Management Systems Exam. Utilize flashcards and multiple-choice questions with hints and explanations. Prepare effectively for your healthcare IT certification!

Multiple Choice

Which of the following is an episode-of-care reimbursement type?

Explanation:
Episode-of-care reimbursement is a bundled, fixed payment set in advance to cover all services needed for a defined patient episode. This forward-looking payment is designed to cover the entire episode, so the price is determined before care begins and the payer assumes the risk for that episode. That makes it the best fit for an episode-based approach. Self-pay involves the patient paying after care and isn’t a payer-defined episode; capitation pays a fixed per-member-per-month amount regardless of the episode; global payment covers all care for a defined population over a period, not a single episode.

Episode-of-care reimbursement is a bundled, fixed payment set in advance to cover all services needed for a defined patient episode. This forward-looking payment is designed to cover the entire episode, so the price is determined before care begins and the payer assumes the risk for that episode. That makes it the best fit for an episode-based approach. Self-pay involves the patient paying after care and isn’t a payer-defined episode; capitation pays a fixed per-member-per-month amount regardless of the episode; global payment covers all care for a defined population over a period, not a single episode.

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