Purchase Solution

Payment methodologies in health care plans

Not what you're looking for?

Ask Custom Question

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.

Purchase this Solution
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.

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 ...

Purchase this Solution
Free BrainMass Quizzes
Vitals about a Patient's Vitals

Basic questions about blood pressure and measurements.

What everyone should know about MRSA

This quiz focuses on what everyone should know about community MRSA. Community MSRA is an infection in healthy people.

Managed Care Organizations

This quiz will test the basics of managed care organizations. It is important to know how our health care delivery system operates through managed care.

First Aid

Do you know how to provide first aid?

CPR (Red Cross Standards)

Are you up to date on your CPR skills? Find out if you know what to do in an emergency with this quiz.

View More Free Quizzes
Related BrainMass Solutions

  • Fee-for-Services and Managed Care Organizations

    368896 Fee-for-Services and Managed Care Organizations 1. Compare and contrast payment methodologies between FFS and MCO plans. 2. Problems that MCOs have experienced when implementing capitation arrangements in specialty care practices.

  • The Effect of Payment Methods on Strategic Management

    The Impact of Payment Methodology on Strategic Management - Payment methodologies and policies are a critical determinant of the success of any health care system.

  • Capitation Payment Methodologies

    511620 Capitation Payment Methodologies Discuss capitation payment methodologies between payers and providers, and Medicare or Medicaid with commercial Managed Care organizations (MCO).

  • Healthcare Legislation and Medical Liability Reforms

    Problems in Health care Law.

  • United States: Healthcare and Insurance

    This shift from fee-for-services to a value-based contracting model represents an evolution in clinical and payment methodologies that in theory will foster greater accountability, and take advantage of innovations in medical technology.

  • Payment Systems

    When the health care system changes (managed care) through policy, then the payment systems are put in place that reflect these policies and new health care systems, which are then used by the health care organizations (HCOs).

  • Characteristics of various popular managed care models

    POS plans offer maximum freedom with minimal co-payment and no deductible. In addition, out of pocket costs are limited. Unfortunately, there is a substantial co-payment for non-network care and a deductible for non-network care.

  • Reimbursement Methods - Managed Care

    Introduction: Changing the method of payment, either through pay-for-performance or high-deductible health plans impact consumers' access to care or quality of care in some fashion, according to research.

  • Healthcare Management Competitive Forces

    In reference to how doctors perceived HMO managed care plans, many physicians believe that these plans are beneficial for controlling health care costs but have an overall negative impact on medical practice.

View More Related Solutions