Healthcare in America. (2017). How do Doctors Get Paid for Healthcare Treatment? Healthcare in America.
Doctors have different ways of being paid, very few of them work for a salary. However, according to an article in the healthcare in America, who did a Gallup survey in 2015, says that now about 90% of Americans have health insurance. In this way, with the co-payments made by the patient and the payments made by the own health insurance, the doctor receives their payment. Weight This is a way to explain how the students receive their payment. However, there are several ways in which doctors receive payment for their services.
1. Fee for services: (FFS) which the payer pays what the doctor, hospital or service provider collects for the service without an established pre-agreement of rates. This form also serves as the basis for the early forms of payment for the service provided. (fee for service with discount). Generally, PPOs use this form of payment.
2.Capitation: Here the physicians, hospitals and health providers, has a rate already determined by serving users enrolled in different health plans, regardless of the cost of the service.
3. Units of relative value: In this case, the doctor’s payment is made by performance, which takes into account the ability, skills and time that doctor in the provision of the service. In this form of payment, the care provided by the physician is more important than the volume of patients. These are called an RVU service.
4. Bundled payments: (BPCI) In this model both hospital expenses and medical expenses are combined to make a payment for the service provided. An example would be an ambulatory surgeon, who paid for the preoperative, postoperative and surgery.
5. Comprehensive primary care: this is a model that encourages physicians to keep healthy patients by establishing a fixed price for a fixed period. The advantage with this program is the flexibility of the doctor to decide the different treatments and the resources of the treatments that required with certain administrative restrictions.
6. concierge care: This is another alternative payment option, where medical practices have a financial relationship with the patient. Generally, a monthly fee is charged to obtain extra benefits such as medical attention from counseling, direct primary care or direct practice medicine. (Healthcare in America, 2017)
Capitation: This is paid periodically to the physician for the service provided, through a managed care group like HMO.
Fee for service: (FFS) here is payment by the providers for the services provided, with predetermined rates. By combining the capitalization for essential services and FFS services, for medical needs, Medicaid can reduce operating costs and absorb the growing number of patients. Due to this growth, capitation motivates preventive medical attention, including home services. On the other hand, the limited services of FFS allow the analysis of costs and allow adjustments between physicians, providers and Medicaid services. (Bunker, 2017)
Fee for services has an incentive system for the admission of patients by medical and diagnostic.
Capitation has an incentive service through preventive care and efficiency in the service.
The truth is that the combination of the two forms of reimbursement are valid, although I think that depends on the age and the geographical location where the person lives. Capitation is a very effective method for me since when there are excellent service and constant prevention. Medical expenses may decrease. On the other hand, it is valid that with the fee for services system, only the treatments and services provided paid for. that is why I believe that the combination of the two services is of benefit for all the parties involved.
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