What Is Cost-Based Reimbursement?

Cost-based reimbursement is a payment method where Medicare pays certain facilities, like a Critical Access Hospital, based on the actual costs they incurred to provide care. This is different from most payment models, which pay a fixed rate for a service regardless of the cost.

Why It Matters

This model helps keep essential rural and other specific types of hospitals financially stable. For patients, it means the billing structure at these facilities might look different from a standard hospital bill.

How Mira Mace Can Help

Your advocate understands the different, complex ways that hospitals are paid. If you receive care at a facility using this model, we can help you interpret your bill and ensure the charges are appropriate for the services you received.