Which of the following is a characteristic of the episode of care reimbursement model?

Study for the Healthcare Reimbursement Exam. Engage with flashcards and multiple-choice questions, each providing hints and explanations. Prepare effectively for your exam!

The episode of care reimbursement model is characterized by payment being made in a lump sum for all related care associated with a patient's treatment during a specific episode, such as a surgical procedure or a chronic illness management plan. This approach consolidates the payments for various services provided across a continuum of care into a single fixed amount.

This model encourages healthcare providers to deliver efficient and coordinated care because they are incentivized to manage resources effectively within the set payment amount. They must balance the costs of services and outcomes, which can lead to better overall care for patients.

In contrast, reimbursement based on each service rendered would not reflect an episode of care model, as it would mean payments are fragmented. Similarly, since patients pay per visit within a model that segregates care, it does not fit the episode of care framework. Lastly, while the episode of care model encourages efficient care delivery, it does not inherently promote limiting services but rather optimizing the quality of care within the financial constraints provided by the lump sum payment.

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