Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 2
Lecture:The Billing Process of Various Health Care Enterprises
Slide content:EOC: Prospective Payment Method Payors establish reimbursement rates in advance for services to be provided over a specified time Based upon average resource use required to provide a level of care for a given set of conditions or a disease Same amount paid regardless of the costs incurred 16
Slide notes:Another type of episode-of-care methodology is the prospective payment method in which payors establish reimbursement rates in advance for packages of health care services for specific problems. The rates are established based on average resource use for the level of care and the services provided. Individual patients may require different levels of resources that correspond to different costs; however, the total resource use should average out over time. 16