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    Payment methodologies in health care plans

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    Compare and contrast payment methodologies between Fee-For-Service (FFS) and Managed Care Organization (MCO) plans.

    Discuss problems that Managed Care Organization (MCOs) have experienced when implementing capitation arrangements in specialty-care practices.

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    Solution Preview

    Both fees for service and managed care organizations provide a method for reimbursing providers for their services. How they really differ is in how the patient pays the provider. Fee-for-service is much like how we purchase goods in everyday life. If an individual needs a service or medication, they pay for that service or medication according to a set price list. This type of payment method can often be costly and unpredictable.

    Managed care organizations essentially act as a middle man between the individual seeking care and the provider. Both the provider and patient contract into a managed care ...

    Solution Summary

    This solution compares and contrasts the payment methodologies employed by the fee-for-service and managed care organization health coverage plans; it also includes an explanation of problems incurred by the use of the capitation arrangement.