Question

25. An insurance plan that pays a bonus based on quality is called a. a DRG plan. b. an HMO plan. c. a capitation plan. d. a value-based plan. bovina doo bolovni deos bovlower a m gods to 26. Under a capitation plan, Sound in 193672 a. payments to providers depend on the number of episodes of care. b. patients pay a share of the bill rather than a set fee. Tot Juoda c. patients pay a set fee for each service provided. boom d. payments to providers depend on the number of enrolled patients. it m banho masas 27. A physician has two capitated patients who pay $40 per month. One makes no visits in March, and the other makes four. The physician's fee-for-service charge is $100 per visit. For these two patients, the physician's revenues for March would be a. $0. b. $480 c. $400. d. $80. wodworson 5 5 000,00 to adorsed or w woyr son Oloven to be 000 DES.CZ 000 €

Answer 1

25. Option D is correct. Value-based plan rewards healthcare providers with incentives based on the quality of care they provide to the patients.

26. Option D is correct. Under a capitation plan, a set fee is paid o the provider for the number of enrolled individuals. Whether the individual take the service or not, the flat fee is to be paid to the provider.

27. Option D is correct. $40*2 = $80.

A capitated contract is a health insurance policy that pays care providers a fixed fee for each patient. Therefore, there are two capitated patients who pay $40 per month. Nothing matters, whether the patient visits the physician 10 times or never visited in the month. The physician will receive his fix payment $40 for each capitated patient.