The visiting nurse is explaining payment systems for home care to an older adult client. Which of the following accurately describes how payment is made in one of these plans?
A) Fee for Service (FFS) is now charged by visit as opposed to by episode.
B) Payment per day is more expensive for the client.
C) P4P is based on diagnosis and how well the agency provides care.
D) With OASIS, payment is based on standard diagnoses
C
Feedback:
In P4P (pay for performance), payment is not only based on a diagnosis, but also on how well the agency provides care to Medicare beneficiaries. A prospective payment system (PPS) for home care was instituted by Medicare in October 2000 and represented a major change in home care reimbursement (called FFS—Fee for Service). FFS is now by episode, rather than for each visit, as it was previously. Payment per day is less expensive for the client, but can require much collaboration among disciplines, so they all visit on the same day (to avoid multiple co-pay fees). With OASIS, payment is based on selected OASIS (Outcome and ASsessment Information Set) outcome measures, the new version of which (OASIS-C) became effective January 1, 2010.
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