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Description 3 file Payments for Health Services Providers Insurance is based on pooling of losses, payment for random losses, risk transfer, and in

October 6, 2024

Description

3 file

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:

• the fee-for-service method

• the cost-plus approach

• population health – capitation

For your assignment, evaluate two global payment systems within healthcare and address each of the following items:

• Define the structure of the payment systems.

• Identify risk to loss of revenue in each system.

• Describe advantages and disadvantages of each system.

• Identify how pay for performance can be added to each payment system.

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