A<unk>  <unk>  is a term used to refer to several<unk>  methodologies for which means of determining insurance reimbursement is based on a predetermined<unk>  regardless of the intensity of the actual service provided. It includes a<unk>  for paying hospitals based on predetermined prices, from Medicare.<unk> s are typically based on codes provided on the insurance claim such as these: * Diagnosis-related groups for hospital inpatient claims * Ambulatory<unk>  Classification for hospital outpatient claims * Current Procedural Terminology for other outpatient claims The<unk>  was established by the Centers for Medicare and Medicaid Services (CMS), as a result of the Social Security Amendments Act of 1983, specifically to address expensive hospital care. Regardless of services provided,<unk>  was of an established fee. The idea was to encourage hospitals to lower their prices for expensive hospital care. In 2000, CMS changed the reimbursement<unk>  for outpatient care at Federally Qualified Health Centers (FQHCs) to include a<unk>  for Medicaid and Medicare. Under this<unk> , health centers receive a fixed, per-visit<unk>  for any visit by a patient with Medicaid, regardless of the length or intensity of the visit. The per-visit rate for the Medicaid<unk>  is specific to the individual health center location. The rate is determined and updated by a financial accounting process conducted by State Medicaid agencies. The FQHC<unk>  rate for Medicare (previously called the All Inclusive Reimbursement Rate), in contrast, is fixed at the same level across different health centers. Aside from FQHCs, other entities that provide outpatient services to Medicaid patients, that are also paid by a<unk>  methodology include: *FQHC look-alikes (health centers not receiving a federal grant under section 330 of the Public Health Service Act, but that otherwise meet the criteria for FQHC status.) *Indian Health Service Health Centers *Rural Health Centers (in some states, like California)
Prospective payment system
Bundled payment
Flexible spending account
Collaborative practice agreement
Fee-for-service
Adverse outcome pathway
Evidence-based practice
Capitation 