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In: Finance

What are the different forms of payment to providers? Why do organizations choose to shift costs...

What are the different forms of payment to providers?

Why do organizations choose to shift costs to other payers?

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Expert Solution

Answer(1):

Different forms of payment to providers- In Medical sector payment is made to the providers using different methods. These are as following:

Per visit payment- As the name suggests, payment is made to the medical officer for each day or per visit. This is made based on predetermined amount regardless of the hours spent.

Example: Skilled nursing facilities like physiotherapy per sitting.

Per episode payment- It is paid as per the services rendered during a particular episode or care. The care or service can extend over many days but payment will be same.

Example: Emergency room visit and hospital impatient services.

Capitation payment- This is the monthly payment given to the medical officer for patients. This amount remains fixed regardless of how many times a patient comes in a month. It is also called per patient payment.

Example: State medical program

Fee for service payment- As the name suggests, this payment is made to the medical officer for the services, he provides. He gets payment based on number of services rendered.

Example: In house medical officer who is employed in hospital and provides several services like consultation, surgery, care etc.

Answer(2):

Organizations choose to shift costs to other payers to offset losses from other payers. Organization compensate and offset their bad debts by shifting cost to other payers.


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