medicare and medicaid reimbursement

How Do Medicare and Medicaid Differ in Terms of Reimbursement?


Medicare and Medicaid reimbursement mechanisms are distinct. Medicare typically uses a prospective payment system where a fixed amount is paid for patient care based on the diagnosis-related group (DRG) classification. On the other hand, Medicaid reimbursement rates are set by individual states and can vary widely. Medicaid often uses fee-for-service or managed care models to reimburse healthcare providers.

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