Health Payer Intelligence January 30, 2017

Healthcare payers will need to consider the risks of capitation payment and bundled payment models when deciding which reimbursement structure to implement.

 

January 30, 2017 – Today, healthcare payers have multiple ways to reimburse providers for performing medical services that move away from the traditional and more costly fee-for-service reimbursement system. Two such possibilities include capitation payment and bundled payment models.

Capitation payment is based on targeting population health management, according to the Harvard Business Review. Today, a number of different payment strategies such as accountable care organizations, shared savings programs, and pay-for-performance contracts have been integrated among payers and providers as a way toward capitation.

Through capitation payments, payers no longer reimburse providers for every service completed as...

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Topics: ACA (Affordable Care Act), ACO (Accountable Care), CMS, Health System / Hospital, Medicare, Patient / Consumer, Payer, Physician, Population Health Mgmt, Primary care, Provider, RCM (Revenue Cycle Mgmt), Value Based
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