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Reimbursement

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Submitted By sajt38
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Comparison Reimbursement Programs and the Movement of Finances in the United States Health Care System

by
Ronald J. Sanders

MBA520, MBOL2, Health Care Organization
Instructor: Dr. Sandra Washington
Saint Leo University
Distance Learning

March 17, 2013

Abstract
Effective payment program strategies are a major part of administering health care. Reimbursement programs are a part of the United States (U.S) health care system. They represent a financial tool for providing cash flow to service physicians and hospitals. Many times, the ability to provide quality health care depends on the payment for the services given by physicians and hospitals. This paper presents a view of payment reimbursement systems within the health care industry. A comparative overview and description of payment reimbursement will be given in order to understand the flow of finances in the health care industry. The focus will be on the capitation and fee-for-service reimbursement systems. Readers will then be able to conclude that the appropriate reimbursement method is dependent upon the amount of risk a party is able to assume.

Comparison of Reimbursement Programs and the Movement of Finances in the United States
Health Care System

Physicians that are part of the managed care system have several methods in which to be compensated or be reimbursed for services. Two popular methods are Capitation and Fee-for-Service. Physicians have confronted several challenges in organizing and financing payment systems for their services. Managed health care has grown considerably within the health care industry. The total financial savings resulting from managed health care as well as the limits on patient freedom are at the forefront of daily news. Insurance risk seems to be one of the less talked about concerns in the move toward providing health care....

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