Question

• Explain prospective payment system (PPS) and give an example of a inpatient PPS. Then explain hospital outpatient prospective payment system and provide an example.

Answer 1

Prospective payment system(PPS)- This is the system in which payment will be calculated annually that was based on hospital charges

Example – the example of inpatient prospective payment system is diagnosis related group (DRG)

The Outpatient prospective payment system (OPPS) is the system in which the medicare decides that how much money will be given to the hospital or to the community mental health centre for the outpatient care to patient with medicare.

Example- low cost drugs and supplies will be added to the cost of surgical and emergency room procedure