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  2. Center for Medicare and Medicaid Innovation - Wikipedia

    en.wikipedia.org/wiki/Center_for_Medicare_and...

    The Center for Medicare and Medicaid Innovation ( CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation.

  3. Value-based health care - Wikipedia

    en.wikipedia.org/wiki/Value-based_health_care

    Value-based health care. Value-based health care ( VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. [1] The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg, though implementation efforts on aspects ...

  4. Pay for performance (healthcare) - Wikipedia

    en.wikipedia.org/wiki/Pay_for_performance...

    In the healthcare industry, pay for performance ( P4P ), also known as " value-based purchasing ", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for ...

  5. Understanding Medicare Reimbursement & Claims - Healthline

    www.healthline.com/.../medicare-reimbursement

    By signing the ABN, you agree to the expected fees and accept responsibility to pay for the service if Medicare denies reimbursement. Be sure to ask questions about the service and ask your ...

  6. Medicare PFFS Plans | Healthline

    www.healthline.com/health/medicare/pffs-medicare

    Medicare Private Fee for Service (PFFS) plans are a type of Medicare Advantage plan. Medicare PFFS plans are offered by private insurance companies.; Medicare PFFS plans are fixed rate-based for ...

  7. Medicare Guidelines for Inpatient Rehab Coverage - Healthline

    www.healthline.com/health/medicare/medicare...

    To ensure Medicare coverage for your inpatient rehabilitation, your doctor will have to certify that you need the following: access to a medical doctor 24 hours per day. frequent interaction with ...

  8. Fee-for-service - Wikipedia

    en.wikipedia.org/wiki/Fee-for-service

    Fee-for-service ( FFS) is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health care quality is mixed ...

  9. Medicare Advantage - Wikipedia

    en.wikipedia.org/wiki/Medicare_Advantage

    Original Medicare typically reimburses healthcare providers with a fee for each service. This fee is often calculated with a standard formula (for example, the prospective payment system for hospital services). Providers either accept Medicare's reimbursement rates or opt out of the program.