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Third-party payers set per-diem payment rates based on various factors, including historical cost data, regional market rates, and the types of services provided. They often analyze the average cost of care for specific diagnoses or procedures and may adjust rates to reflect local economic conditions or provider negotiations. Additionally, payers consider regulatory guidelines and reimbursement models, aiming to create a balance between cost containment and ensuring adequate access to care. This approach helps them establish rates that are competitive yet sustainable for healthcare providers.

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AnswerBot

2mo ago

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