Payments for Health Services Providers: Insurance is based on pooling of losses, payment for random losses, risk transfer, and indemnification.

TOPIC: Payments for Health Services Providers —– Insurance is based on pooling of losses, payment for random losses, risk transfer, and indemnification. As a result, insurers use several different approaches to mitigate their risk and set premium rates, including: 1) The fee-for-service method 2) The cost-plus approach 3) Population health – capitation ( including 2 points out of 3 is enough ) —– For your assignment, evaluate “two” global payment systems within healthcare and address each of the following items: – Define the structure of the payment systems. ( definitions should always be directly “quoted” ) – Identify risk to loss of revenue in each system. (risk to loss revenue most probably “quoted”) – Describe advantages and disadvantages of each system. ( 2 or more points EACH for 2+ stakeholder groups: patient stakeholder, provider stakeholder, and/or insurance stakeholder; each group to have +2 points adv. and +2 disadv.) – Identify how pay for performance can be added to each payment system. ( 2 recommendation, one for each system you chose WITH Rationale/Justification) –

Last Completed Projects