Which reimbursement system is driven by resources and prospective payment?

Which reimbursement system is driven by resources and prospective payment?

• A. Direct Billing
• B. Cost-Based Reimbursement
• C. Resource Based Reimbursement
• D. Fee-for-Service

Answer: (C)

The reimbursement system characterized by being driven by resources and using a prospective payment model is Resource Based Reimbursement. This system emphasizes the allocation of payment based on the anticipated resources required to deliver care for specific diagnoses or treatments. In this model, payments are determined before services are provided, allowing healthcare providers to understand the financial resources they will receive for each episode of care regardless of the actual costs incurred. This proactive approach encourages efficiency and cost-effective care delivery as providers are incentivized to use resources judiciously. Unlike other systems such as cost-based reimbursement, which compensates based on the actual costs incurred, or fee-for-service, where providers are paid for each service rendered without a fixed budget for a specific episode of care, resource-based reimbursement focuses on the expected resources necessary for treatment outcomes. This approach aligns with broader healthcare initiatives aimed at controlling costs while maintaining quality care.

The reimbursement system characterized by being driven by resources and using a prospective payment model is Resource Based Reimbursement. This system emphasizes the allocation of payment based on the anticipated resources required to deliver care for specific diagnoses or treatments.

In this model, payments are determined before services are provided, allowing healthcare providers to understand the financial resources they will receive for each episode of care regardless of the actual costs incurred. This proactive approach encourages efficiency and cost-effective care delivery as providers are incentivized to use resources judiciously.

Unlike other systems such as cost-based reimbursement, which compensates based on the actual costs incurred, or fee-for-service, where providers are paid for each service rendered without a fixed budget for a specific episode of care, resource-based reimbursement focuses on the expected resources necessary for treatment outcomes. This approach aligns with broader healthcare initiatives aimed at controlling costs while maintaining quality care.