Cost-based, charge-based, and contractual payment systems-CRC Press (2013)
This book has been prepared to address various complexities by iterating certain concepts. This means that we address a concept or topic at a high conceptual level and then revisit the same or perhaps a similar topic and drill down with more detail. Due to the extreme complexities of most payment systems, we are only able to address many topics at a detailed conceptual level. For this text, our goal is to understand many of the features and the way in which payment systems function. When these systems are in use to actually reimburse healthcare providers, they are dynamic and are constantly changing and evolving. The level of detail provided concerning cost-based, charge-based, and contractual payment arrangements has been balanced with the number of conceptual features that are presented. To fully discuss any of the many issues addressed would take a separate book. For instance, Chapter 5 briefly addresses capitated healthcare payment. To really discuss capitated payment systems, a rather large volume would be needed. The intent is to provide a framework to understand and analyze the characteristics of the payment systems discussed in this text. Thus, the intended level is that of a detailed conceptual discussion. The concepts can then be applied to a wide variety of specific circumstances
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