The second main type of physician reimbursement is payment per case treated. This provides a strong incentive for physicians to provide FEWER services, given that the physician receives compensation on per-case basis, and pockets any leftover funds as profits not devoted to patient care. It substantially incentives physicians accepting healthier patients with less expensive medical conditions (Jacobs & Rapoport 2002: 150). However, for this reason and the lack of monitoring afforded by third parties regarding quality of care, the per case model is seldom used.
In the United Kingdom, physicians are paid a salary, rather than upon a per-service basis. They physician is encouraged to be a 'gatekeeper' in reducing fees, much as insurance agencies act as gatekeepers within the United States (Jacobs & Rapoport 2002: 150-151). The salary system is designed to incentivize providing patient care in a similar manner to all patients. It encourages physicians to evaluate treatments based upon patient need, rather than the likelihood of personally profiting from more expensive care. Although this system might seem to encourage physicians to provide the absolute minimum of service, in theory physicians cannot allow the quality of care to sink below a certain level. This salary model is designed to lower cost expenditures, which is deemed to be necessary under the UK's NHS (National Health System) (Gold 2011).
While the U.S. has resisted adopting many features of the NHS system, it has attempted to curtail the abuses of the fee-for-service system through the use of capitation, or a fee paid to a physician for patient participant in a health plan. This system, most frequently manifested in...
In this way, any concerns that could come up and be problematic will be avoided and the information contained in the study can be accepted as being reliable, valid, and unique. As has been mentioned, limitations are too often overlooked in studies, and it is often impossible to find all of the limitations that are contained in a study and spell them out for all to see. However, that does
Reimbursement and Pay-For-Performance Pay-for-performance This entails day-to-day programs designed to offer monetary incentives to health care providers and physicians to meet efficiency, quality and other defined targets. Pay-for-performance entails Agency for health care and quality, which defined as improved strategies in health care delivery, which majorly relies on the use of purchase power or the market power (Heywood, 2002). They referred as proper a financial incentive that heavily rewards service providers for
Hospital administrators must take into consideration the role of reimbursement by health insurance companies when allocating finite resources and in assessing how patients will evaluate different treatment options. One of the most common examples of this is the rise of pay-for-performance incentives. “A pay-for-performance program provides a bonus to health care providers if they meet or exceed agreed-upon quality or performance measures, for example, reductions in hemoglobin A1c in diabetic
Note that the organization at CardioCenter is significantly different than that of a cardiology center at an Orlando-area medical center in several key ways: The communication between the EMT's and the EMT-focused nurse begins well before it does at the generalist hospital, saving minutes upon entry of the patient. There is no delay for billing information or to find the appropriate physician. They have already been alerted and are on standby There is
This is important because the cost of hospital acquired infections run high. The cost to care for a patient with a hospital acquired infection is almost three times the amount to care for a patient without a hospital acquired infection (Hassan et al., 2010). Since hospital acquired infections can be attributed to the hospital, Medicare and Medicaid will no longer cover payment of these infections beginning in 2008. Medicare and
AbstractThe Overkill case study discusses issues around low-value care and ways of minimizing healthcare costs while increasing the quality of output. Low-value care is the administration of health interventions whose costs or harms exceed benefits. It arises from information asymmetry between the doctor and their patient. The doctor has a lot of knowledge on treatment plans, while the patient has little knowledge and relies fully on the doctor�s recommendations. The
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