Homework: Strategic Management Project- Risk-Based Reimbursement
Length: 4 to 5 pages.
For your homework, a primary care physician is often reimbursed by Health Maintenance Organizations (HMOs) via capitation, fee-for-service, relative value scale, or salary. Capitation is considered as a risk based compensation.
In an effort to understand the intricacies involved with physician reimbursement, particularly in an era of health care reform, identify and interview an expert in the field, such as:
i. Hospital Administrator
ii. Managed Care Organization (MCO) executive
iii. Health care Consultant
iv. Legal Professional
Assumption: MCOs use risk-based reimbursement for primary care physicians.
Ask the following questions in the interview:
i. What kind of risk do the MCOs assess?
ii. Does risk-based compensation limit the freedom of primary care physicians in any way in terms of patient care? Why or why not?
iii. How does the capitation model of reimbursement work? Do physicians generally prefer one model over the other? Why or why not?
iv. Why do HMOs prefer the prepaid, monthly premium?
v. Is pay-for-performance a better model than existing models of compensation? Are there limitations to it as well?
Format your homework according to the following formatting requirements:
i) The answer should be typed, using Times New Roman font (size 12), double spaced, with one-inch margins on all sides.
ii) The response also includes a cover page containing the title of the homework, the student's name, the course title, and the date. The cover page is not included in the required page length.
iii) Also include a reference page. The Citations and references must follow APA format. The reference page is not included in the required page length.