Mcos reimburse providers for health care services


Problem: With the increasing cost of health care, MCOs have been under tremendous pressure to control health care costs, including physician reimbursement. In this assignment, you are to look at some of the issues that are involved in physician reimbursement.

Your assignment pages paper that addresses the following:

  • What are the different methods that MCOs reimburse providers for health care services?
  • How does reimbursement for these services vary based on the type of MCO models (Group, Staff, IPA, PPO...)
  • In which situations would member/patients pay the MCO directly?
  • How reimbursement impacts how care is delivered to the patient?
  • Is this good or bad? Provide examples,
  • Cite your resources.

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