A review of Medicare's PPS system in relation to patient convenience and office efficiency.
Written in 2005; 1,125 words; 23 sources; $ 44.95
Paper Summary:
This paper focuses on issues surrounding Medicare's PPS system. Topics covered in this paper are: medical economics and finances, and regulatory problems. The focus of this paper is on the excessively frequent regulatory changes in addition to the numerous structural overhauls to the system and the corresponding issues that providers have to deal with, usually just opting to write off limited claim amounts as opposed to spend time and energy on resolving them.
From the Paper:
"Medicare's Prospect Payment System (PPS) is a system established by Medicare to pre-authorize services based on service and provider type in order to expedite services to Medicare recipients, negating the need for approval for services and ostensibly increasing delivery time to the patient. PPS has been around for inpatient services since the 1980s; however, the Out-Patient Prospect Payment System (OPPS) has only been active for five years and is modified on a continual basis. All services paid under this system are classified into groups called APCs (Crishock, 2005). The services provided in each APC are similar clinically and in terms of the required resources. A payment rate is established for each APC."
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