Question

What are the different forms of payment to providers?

Why do organizations choose to shift costs to other payers?

Answer 1

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.