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Prospective Payment Systems (PPS)

A Medicare payment plan including pre-determined payment rates based on a patient's diagnosis or level of resource utilization. All Medicare providers are reimbursed under this plan through either a scheduled fee or prospective payment system.

Small Business Health Options Program (SHOP)

Similar to the individual market exchanges (or marketplaces) the SHOP exchanges allow small businesses to select health plans for their employees (or contribute to employee…