Risk-Based Reimbursement
To your Dropbox task, a major care doctor is usually reimbursed by Well being Upkeep Organizations (HMOs) by way of capitation, fee-for-service, relative worth scale, or wage. Capitation is taken into account as a danger based mostly compensation.
In an effort to know the intricacies concerned with doctor reimbursement, notably in an period of well being care reform, establish and interview an skilled within the subject, similar to:
Hospital Administrator
Managed Care Group (MCO) govt
Well being care Marketing consultant
Authorized Skilled
Assumption: MCOs use risk-based reimbursement for major care physicians.
Ask the next questions within the interview:
What sort of danger do the MCOs assess?
Does risk-based compensation restrict the liberty of major care physicians in any manner when it comes to affected person care? Why or why not?
How does the capitation mannequin of reimbursement work? Do physicians typically want one mannequin over the opposite? Why or why not?
Why do HMOs want the pay as you go, month-to-month premium?
Is pay-for-performance a greater mannequin than current fashions of compensation? Are there limitations to it as effectively?
Be at liberty so as to add further follow-up questions for depth and clarification as you see match.
Create a Four- to 5-page report in Microsoft Phrase doc, analyzing the responses supplied (which needs to be included as a part of the report) utilizing the proof from the literature to Help Help or refute the responses supplied.
Help your responses with examples.
Cite any sources in APA format.
Submission Particulars
Title your doc SU_HCM4025_W5_A2_LastName_FirstInitial.doc.
Submit your doc to the W5 Task 2 Dropbox by Tuesday, September 19, 2017.
Task 2 Grading CriteriaMaximum PointsAnalyzed and chosen an acceptable candidate for the interview and requested required questions.100Analyzed responses to the required questions.100Written Parts.50Complete:250
