Problem
1. What reasons could account for the gap between the reimbursement for multidisciplinary care and the expenses of delivery of multidisciplinary care?
2. In evaluating the RBRVS reimbursements for the physician practice, what other data should the intern consider? The intern notes that code 99205 has the highest RVU. Explain whether the intern should advise the practice to recruit more very sick new patients (office visit, new patient, high complexity).
3. Describe the elements of the outpatient and inpatient prospective payment system.
4. Why does the IPF PPS length-of-stay adjustment factor grow smaller during the patient encounter?
5. Describe at least two of the patient-level adjustments for IPF PPS claims and why they are used.
6. Envision governmental involvement and incentive initiatives for providing cost effective healthcare.