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Title: Several reimbursement methodologies were described in this chapter. What incentive would a provider ... Post by: sophie0209 on Feb 5, 2018 Several reimbursement methodologies were described in this chapter. What incentive would a provider have to participate in each reimbursement type?
What will be an ideal response? Title: Several reimbursement methodologies were described in this chapter. What incentive would a provider ... Post by: saldii43 on Feb 5, 2018 Providers may like capitation managed care plans because they get regular income, whether the patients are ill or not.
Providers may like PPO plans because they offer a compensation structure more similar to their own fee-for-service business. Providers may like traditional fee-for-service plans because they set their own charges and feel more in control of their own business. Most providers are sensitive to their marketplace and choose to participate in plans that a majority of the population in their community have. If a large employer switches to a managed care plan, doctors may have to participate in that plan or risk losing patients. Providers are required to treat Medicare patients; the law limits the amount a nonparticipating provider can charge to nearly the same amount a participating provider would be paid for the same service, thus there is no financial incentive not to participate. |