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A sliding fee scale based on income is implemented so that the cost of care is proportionate to the patient's ability to pay. The purpose of these stipulations is to ensure that CHCs are working alongside the community, instead of just serving the community, in order to improve access to care.
Sliding scale fees are variable prices for products, services, or taxes based on a customer's ability to pay. Such fees are thereby reduced for those who have lower incomes, or alternatively, less money to spare after their personal expenses, regardless of income. [1] Sliding scale fees are a form of price discrimination or differential pricing.
For dentists, the American Dental Association defines a usual and customary fee as "the fee an individual dentist most frequently charges for a specific dental procedure independent of any contractual agreement. It is always appropriate to modify the fee based on the nature and severity of the condition being treated and by any medical or ...
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It is a fee-for-service model. The Act allowed the creation of accountable care organizations (ACOs), which are groups of doctors, hospitals and other providers that commit to give coordinated care to Medicare patients. ACOs were allowed to continue using fee-for-service billing.
This practice was known as sliding fees and became a legal rule in the 20th century in the U.S. [7] [10] Eventually, changing economic conditions and the introduction of health insurance in the mid-20th century ushered an end to the sliding scale. [11]
[136] [137] Of each dollar spent on healthcare in the US, 31% goes to hospital care, 21% goes to physician/clinical services, 10% to pharmaceuticals, 4% to dental, 6% to nursing homes and 3% to home healthcare, 3% for other retail products, 3% for government public health activities, 7% to administrative costs, 7% to investment, and 6% to other ...
However, "in the private fee-for-service context, the loss of specialist income is a powerful barrier to e-referral, a barrier that might be overcome if health plans compensated specialists for the time spent handling e-referrals." [20] In Canada, the proportion of services billed under FFS from 1990 to 2010 shifted substantially. [21]
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