Explain how capitation works in regard to physician


1.What is the goal of managed health care? What does it strive to do?

2. What is the role of a primary care physician (PCP) in a traditional HMO?

3. Explain how capitation works in regard to physician reimbursement.

4. Have pay-for-performance (P4P) programs been effective? Why or why not?

5. Differentiate between pre-auth and pre-cert.

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