When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...

Question

Question

When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...

When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome that is beneficial to the payer and a scenario that is beneficial to the provider.

science nursing

Add a comment Improve this question Transcribed image text

Answer 1

Answer #1

Managed care organization work in together with the provider and the insurance company. Here the provider sets the amount for the services and the insurance company has to pay for it.

For example:

If a patient has come to visit a provider for an annual physical checkup or doing a annual health Check up. Here the payer is beneficial as a whole and the provider is beneficial by providing particular service yo the patient.

Add a comment

Answer 2

Similar Homework Help Questions

Pay-for-Performance (P4P) was introduced through managed-care organizations as a method of offering financial incentives to physicians...

Pay-for-Performance (P4P) was introduced through managed-care organizations as a method of offering financial incentives to physicians to help facilitate evidence-based medicine, improve overall quality, and promote better outcomes. As P4P evolved (both for hospitals and for physicians), new issues, challenges, and opportunities for improvement evolved as well (Kongstvedt, 2013). When did this program officially start?
Preferred provider organizations (PPOs) are relatively new forms of managed care. Preferred provider organizations are: Select...

Preferred provider organizations (PPOs) are relatively new forms of managed care. Preferred provider organizations are: Select one: a. Physician organized groups that provide discounted medical treatment to underprivileged or disadvantaged groups of people b. Organizations of physicians and other health care professionals who charge a standard, hourly fee for services c. Organizations created by insurance providers which offer medical coverage with doctors inside and outside of the organization's guidelines d. Created by insurance companies via networking with physicians and hospitals...
What is the difference between traditional fee for service and managed care? Describe the positive and...

What is the difference between traditional fee for service and managed care? Describe the positive and negative effects of a system of prospective reimbursements of health care providers, i.e. a capitation or fixed payment per capita system.

Differences in Managed Care and Fee-for-service. Does managed care give greater accountability for quality of care...

Differences in Managed Care and Fee-for-service. Does managed care give greater accountability for quality of care than fee-for-service
Describe the principles of fee-for-service plans and managed care plans. What are the similarities and differences?...

Describe the principles of fee-for-service plans and managed care plans. What are the similarities and differences? DO NOT PLAGIARIZE. ORIGINAL ANSWER ONLY
Risk-Based Reimbursement For your assignment, a primary care physician is often reimbursed by Health Maintenance Organizations...

Risk-Based Reimbursement For your assignment, a primary care physician is often reimbursed by Health Maintenance Organizations (HMOs) via capitation, fee-for-service, relative value scale, or salary. Capitation is considered as a risk based compensation. In an effort to understand the intricacies involved with physician reimbursement, particularly in an era of health care reform, identify and interview an expert in the field, such as: Hospital Administrator Managed Care Organization (MCO) executive Health care Consultant Legal Professional Assumption: MCOs use risk-based reimbursement for...

Managed care organizations emphasize physicians' responsibilities to control patient access to expensive hospitalization and specialty care,...

Managed care organizations emphasize physicians' responsibilities to control patient access to expensive hospitalization and specialty care, a principle dubbed "gatekeeping." Some argue that "gatekeeping" is unethical because it introduces financial factors into treatment decisions. Others say it improves quality by promoting the use of the most appropriate levels of care.
Compare the procedures for filing fee-for-service and managed care claims under Medicaid.

Compare the procedures for filing fee-for-service and managed care claims under Medicaid.
What are the common characteristics of managed care organizations? Identify and describe the three major types...

What are the common characteristics of managed care organizations? Identify and describe the three major types of managed care organization’s remuneration/payment plans to providers?

describe the basic structure of state and federal oversight of managed care organizations (MCOs).

describe the basic structure of state and federal oversight of managed care organizations (MCOs).

When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...

Homework Answers

Add Answer to:
When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...

Post as a guest

Earn Coins

Pay-for-Performance (P4P) was introduced through managed-care organizations as a method of offering financial incentives to physicians...

Preferred provider organizations (PPOs) are relatively new forms of managed care. Preferred provider organizations are: Select...

What is the difference between traditional fee for service and managed care? Describe the positive and...

Differences in Managed Care and Fee-for-service. Does managed care give greater accountability for quality of care...

Describe the principles of fee-for-service plans and managed care plans. What are the similarities and differences?...

Risk-Based Reimbursement For your assignment, a primary care physician is often reimbursed by Health Maintenance Organizations...

Managed care organizations emphasize physicians' responsibilities to control patient access to expensive hospitalization and specialty care,...

Compare the procedures for filing fee-for-service and managed care claims under Medicaid.

What are the common characteristics of managed care organizations? Identify and describe the three major types...

describe the basic structure of state and federal oversight of managed care organizations (MCOs).

When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...

Homework Answers

Add Answer to: When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...

Post as a guest

Earn Coins

Add Answer to:
When managed care organizations pay primary care physicians using fee-for-service, describe a scenario with an outcome...