Comparing Healthcare Payment Models Essay

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Description

Capitation is the payment method agreed in a per capita contract between a health insurance company and a health care provider. These are fixed, predetermined monthly payments received by a doctor, clinic, or hospital per enrolled patient or capita. Bundled payment is the method when providers such as doctors or hospitals are paid for bundles of services rather than for each service they pay for. At the same time, fee-for-service reimbursement addresses the method that implies the payments for each service provided to a patient by the provider.

Similarities

Capitation and fee for services are both based on the insurance program. The bundled payments system is similar to the cost of assistance in analyzing the potential needs of individual patients (Bundled Payments, 2019). At the same time, this method addressed the correlation between race, gender, nationality, and the possible amount of health consulting. In other words, capitation shares the traits of the population analysis with the bundled payments.

Differences

The significant difference in the focus of care is in the capitation and fee for services. In the first case, the health of the assigned population is addressed, while in the second case, the medical organization works with individual patients. Moreover, capitation implies a fixed periodical payment while the service fee provides bills for provided services (Capitation vs. service fee, n.d.). At the same time, bundled payments are centered not on the exact services, patient, or population but on the episode of care. In other words, this method can be called an objectively optimal variant of the three mentioned by providing the full range of services to the patient. However, each organization decides on reimbursement methods separately, led by the healthcare organization’s structure, planning, and opportunities.

References

(2019). ALTARUM. Web.

. (n.d.). Diffen. Web.

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IvyPanda. (2024, April 17). Comparing Healthcare Payment Models. https://ivypanda.com/essays/comparing-healthcare-payment-models/

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"Comparing Healthcare Payment Models." IvyPanda, 17 Apr. 2024, ivypanda.com/essays/comparing-healthcare-payment-models/.

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IvyPanda. (2024) 'Comparing Healthcare Payment Models'. 17 April.

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IvyPanda. 2024. "Comparing Healthcare Payment Models." April 17, 2024. https://ivypanda.com/essays/comparing-healthcare-payment-models/.

1. IvyPanda. "Comparing Healthcare Payment Models." April 17, 2024. https://ivypanda.com/essays/comparing-healthcare-payment-models/.


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