01369e17_Provider_Reimbursement_System___Setting_Methodology_Component
[Description] The state sets an interim rate for a service and then conducts a cost-settlement at the end of year and determines whether services provided cost more or less during the year than the interim rates paid during the year. The provider usually receives a settlement payment if actual costs were higher, or is responsible for a repayment if actual costs were lower.
Rate Settlement Process
F e e f o r S e r v i c e R a t e s
C o s t B a s e d R a t e s
R a t e S e t t l e m e n t P r o c e s s
P r o s p e c t i v e P a y m e n t R a t e s
M e d i c a r e R a t e s
P e r D i e m R a t e s
P a y f o r P e r f o r m a n c e
C a p i t a t e d R a t e s
Q u a l i t y I n c e n t i v e s
Provider Reimbursement System
Rate Setting Methodology/Component