Capitations Significant Impact on The Role of A Physician Discussions

I’m stuck on a Health & Medical question and need an explanation.

1) UNDERSTANDING THE CHARGEMASTER: REAL WORLD CASE STUDY

Real World Case

Reimbursement rules require that the charge master drives a facility’s charges. To receive the optimal reimbursement for services rendered, the charge master must be up-to-date and all-inclusive and must meet any payer rules and regulations.

The XYZ facility has decided to undergo a review of its charge master to ensure that it meets the above criteria. In addition to the comprehensive evaluation, one of the other objectives of the project will be to institute the procedures to ensure that all additions, revisions, and deletions meet the charge master standards. Respond to questions below Capitations Significant Impact on The Role of A Physician Discussions.

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How could the facility measure the success of the charge master review project?

Which facility departments should be included on the project team? Describe the role and responsibilities of each team member?

Who would be the most appropriate project sponsor? Who are the project stakeholders? Capitations Significant Impact on The Role of A Physician Discussions

2) UNDERSTANDING HEALTHCARE PAYMENT SYSTEMS

Explain how fee for service and capitation payment systems affect the physician’s role as the patient’s agent? Second, the move from cost-based payment for hospital services to payment on DRGs was expected to change hospital behavior. Discuss what you would have expected to observe as payment methods changed? Capitations Significant Impact on The Role of A Physician Discussions