Which of the following are the two main types of healthcare reimbursement models?

Study for the Healthcare Reimbursement Exam. Engage with flashcards and multiple-choice questions, each providing hints and explanations. Prepare effectively for your exam!

The option of fee-for-service and capitated payment represents the two primary types of healthcare reimbursement models because they embody distinct approaches to compensating healthcare providers for their services.

Fee-for-service is a model where providers are paid for each individual service they render. This model incentivizes volume and can lead to better patient access as well as a focus on treatment, but it may also potentially encourage over-utilization of services.

Capitated payment, on the other hand, involves a set fee paid to healthcare providers for a defined period for each enrolled patient, regardless of how many services the patient uses. This model encourages providers to focus on preventative measures and efficient care, as their revenue does not increase with the number of services provided.

These two models cover a spectrum of healthcare payment that significantly influences how care is delivered and how providers manage patient health.

The other options represent lesser-known or specific forms of reimbursement but do not encompass the broad and fundamental types represented by fee-for-service and capitated payment. For instance, pay-per-visit is a variation of fee-for-service but does not account for the larger strategic structure of reimbursement models. Indemnity plans focus more on insurance coverage than payment models per service or capitation, while global budgeting and case management models

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