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MCS,PHD
Argosy University/ Phoniex University/
Nov-2005 - Oct-2011
Professor
Phoniex University
Oct-2001 - Nov-2016
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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