MHA 706 Midterm Exam (Lord) – Q&A (Graded A+) Alternative forms of business organization ✔️Ans - 1. proprietorships and partnerships
- corporations
- hybrid forms
proprietorships and partnerships ✔️Ans - pros: ease of information,
subject to a few regulations, no corporation income taxes.cons: limited life, difficult to transfer, unlimited liability, difficult to raise capital.corporations ✔️Ans - pros: unlimited life, easy transfer of ownership, limited liability, ease of raising capital.
cons: cost of formation and reporting, double or triple tax must be paid.
Hybrid forms of business organizations ✔️Ans - LLP, LLC,PC, PA Non-profit organization ✔️Ans - exempt from taxes - goal is to improve community For-profit organization ✔️Ans - investor owned goal is to maximize shareholder return - owes taxes agency problem ✔️Ans - hire someone to carry out a job function, but they go out of their interests instead of best interest of company Third party payor system ✔️Ans - private vs public insurance private insurance ✔️Ans - blue cross blue shield, commercial insurers, self-insurers public insurance ✔️Ans - Medicare and Medicaid both offer services to different levels safety net lowest reimbursement rates 1 / 2
reimbursement methods ✔️Ans - fee for service cost based charged base prospective payment capitation fee for service ✔️Ans - payment is tied to amount of services provided (decades ago) dental industry cost based ✔️Ans - payer pays all allowable cost ex. payment to critical access hospitals charged based ✔️Ans - payer pays billed charges ex. payment on a rate schedule prospective payment ✔️Ans - have fixed payments per diagnosis basis capitation ✔️Ans - payment is tied to size of covered populations (Number of enrollees) payment is based on per number per month decreasing utilization population healthier Medicare reimbursement for different types of providers ✔️Ans - IPPS OPPS Physician Fee Services Inpatient Prospective Payment System (IPPS) ✔️Ans - each DC is assigned to a Medicare severity diagnosis Outpatient Prospective Payment System (OPPS) ✔️Ans - each DC is assigned to ambulatory classifications (APC) Physician fee services ✔️Ans - each service has a relative value unit (RVU) services are standardized Impact of the ACA on healthcare ✔️Ans - created new standards, individual mandates, exchanges and Medicaid expansion,
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