Becker's Healthcare October 8, 2018
Medicare Advantage plans are increasingly using a “full-risk” model that moves financial exposure from patients to physician-management companies, according to a Kaiser Health News report.
Four things to know:
1. Under the full-risk model, physician-management companies receive a monthly fixed payment from private Medicare Advantage plans, rather than payment for each patient visit. The fixed monthly payment covers various areas of care for beneficiaries, including drugs, physician services and hospital stays.
2. Humana, UnitedHealthcare and other Medicare plans are increasingly using the full-risk model to move financial risk to physician-management companies, according to the report. Physician-management companies receive more money upfront and profit if the fixed monthly payment exceeds expenses. Therefore, they focus on keeping patients healthy and preventing costly...
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