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Pros And Cons Of Four Provider Pay Methods

549 Words3 Pages

Explain the pros and cons of four provider payment methods: (a) fee-for-service; (b) capitation; (c) global capitation; and (d) bundled payment.
The fee for service method the physician is paid for an amount per the average of patients that they have seen and which procedure that are used to treat a patient. Through the fee for service there are no fixed payments based on the providers billing for their services upon being delivered. No insurance companies are involved with the fee for service. “Renee Laux & Laura Jean Cataldo (2013) reports A major disadvantage to the patient of an HMO is that his or her preferred health care provider may not have a contract with that HMO and therefore, if the patient wants to see that particular provider, he or she would have to pay for the visits out of pocket. Another disadvantage of HMOs can be that providers may end up being at a financial disadvantage because of the reduced fees required to contract with the HMO. In some areas, this has led to very few healthcare providers contracting with certain HMOs and thus the members of the HMO have very little choice in whom to see.” …show more content…

Capitation provides a financial certainty that other insurance options does not have.
Global Capitation has a similar structure of the standard capitation as such it would allow physicians to accept payments for patients that are enrolled, yet, it would increase based on an annual rise of inflation and if justified. The physician must set up a budget of care for patients with chronic care issues and promote a better health initiate for families to live a healthier life.
Bundle payments are set up for multiple services from four different care link payments that are arranged that are financially accountable. The services are consisted of higher quality and could lead to lower cost

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