Reference no: EM13202105
Part 1 Health plans may pay a physician a per member, per month (PMPM) capitation payment for each person he or she is responsible for. Capitation is a payment methodology used in the health care industry. The chief financial officer (CFO) has asked you to create a brief summary of information regarding capitation. Gather information for the CFO's upcoming meeting to explain capitation and its relation to your hospital. Research and discuss the following with your colleagues:
• An explanation of capitation
• New trends in capitation payments over the last few years (at least 4)
• Whether capitation is effective or efficient (and why)
• The pros and con of working with capitation
Please cite reference Part 2 In health care, services are most likely to be provided before a payment has been received, so it is imperative for health care providers to establish a reimbursement system that fits their individualized operational needs. In a 3-4-page paper, identify the pros and cons of the following reimbursement methods:
• Prospective-payment systems
• Cost-reimbursement systems
• Discounted-charge systems
• Flat-rate reimbursement system
You should consider the following questions in your comparison analysis:
• When is each reimbursement system considered the preferred method?
What types of providers use each system?
• When would be a time or situation when each would be used?
• How does each reimbursement system affect the various departments of health care companies and providers?
• Will choosing one system over another affect available funding sources?
• What other areas/people may be affected by the decision? Please cite reference
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