What defines a "bundled payment" model?

Prepare for the Certified Specialist Payment Rep Exam with detailed flashcards and multiple-choice questions. Each question includes hints and explanations to help boost your readiness. Master your exam preparation journey now!

A bundled payment model is characterized by a single payment that covers a set of related services provided to a patient during a specific episode of care. This approach is designed to promote efficiency and accountability among healthcare providers, as it incentivizes them to deliver quality care within a predetermined price. By grouping various related services, such as medical procedures and follow-up care, into one payment, bundled payments streamline administrative processes and can reduce overall healthcare costs for both providers and patients.

In contrast, other payment models offer different arrangements. For instance, a fixed amount per day for inpatient care focuses on per diem rates, which doesn't accommodate the specifics of bundled services. A percentage discount off billed charges may not account for the comprehensive nature of care provided during an episode. Lastly, payment based on resource utilization emphasizes the costs incurred rather than a set price for a collection of services, missing the core concept of bundling in the payment structure.

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