Give your opinion on peer response to the following question. (Tynisha Gamble)
- Compare and contrast primary available economic resources that health insurance payers may use to monitor, assess, and regulate health care providers behavior. Evaluate the degree to which alternative provider payment methods (e.g., capitation, pay for performance, etc.) impact HMO economic and business performance. Provide one example of such a type of method to support your response
According to (Patrick Alguire, 1), Capitation payments are used by managed care organizations to control health care costs. Capitation payments control the use of health care resources by putting the physician at financial risk for services provided to patients. Capitation is a fixed amount of money per patient per unit of time paid in advance to the physician to deliver health care services. The ranges of services provided determine the amount of money paid, the number of patients involved, and the period during which the services are provided.
When the primary care provider signs a capitation agreement, a list of specific services that must be provided to patients is included in the contract. The capitation amount will be determined in part by the number of services provided and will vary from health plan to health plan. However, most capitation payment plans for primary care services include the following:
- Preventive, diagnostic, and treatment services
- Injections, immunizations, and medications administered in the office
- Outpatient laboratory tests are done either in the office or at a designated laboratory
Reference
Patrick Alguire. 2021. Understanding Capitation. https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/understanding-capitation.
Yong PL, Saunders RS, Olsen LA. 2010. The healthcare imperative lowering outcomes. https://www.ncbi.nlm.nih.gov/books/NBK53906/.
What Students Are Saying About Us
.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐"Honestly, I was afraid to send my paper to you, but you proved you are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"
.......... Customer ID: 11***| Rating: ⭐⭐⭐⭐⭐
"This company is the best there is. They saved me so many times, I cannot even keep count. Now I recommend it to all my friends, and none of them have complained about it. The writers here are excellent."
"Order a custom Paper on Similar Assignment at essayfount.com! No Plagiarism! Enjoy 20% Discount!"
