Question

Q 2.9 Briefly describe how Medicare pays for the following: a. Inpatient services b. Physician service

Answer 1

Medicare payments for the following :

a. Inpatient Services :  Using Inpatient Prospective Payment System, medicare pays to the hospitals for beneficial discharge of the inpatients. The discharge rate varies for every diagnosis , it is called as Diagnosis Related Groups (DRG). DRG's that required higher care and longer stay are assigned higher payments.

b. Physician service : Medicare pays the physicians based on a fee - schedule for different treatments or services. Payment cost for these treatments are decided based on the relative, average costs of providing each to a Medicare patient, and then adjusted to other accounts which include malpractice Insurance, office based practice costs and other expenses . This process is known as Resource Based Relative Value Update Scale.