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Quality Healthcare Services & Traditional Reimbursement Models Paper

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User Generated
Subject
Health & Medical
Type
Research Paper
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Running Head: HEALTHCARE 1
Healthcare
Student Name
Institution
Date

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HEALTHCARE 2
Reimbursement
Maxcare is a for-profit private owned hospital. It is an exclusive approved hospital
that provides quality healthcare services to the patients. For an organization to maintain its
financial sustainability, it must use the right and most suitable type of reimbursement. In
healthcare there are both traditional reimbursement models and the modern reimbursement
models. The traditional models are cumbersome and costly and they are capitation and Fee
for Service (FFS) Payments methods. Maxcare uses the modern reimbursement method
commonly referred to as value-based reimbursement that focus on quality health service and
the service providers using this model are rewarded based on the health outcome of the
patient. This method is less costly and gives best quality service to the patients hence
enhancing sustainability of the hospital (Loblova, 2020).
Out- of- pockets are the direct individual payments to the healthcare providers at the
time of the use of service and they majorly serve to sustain healthcare service provisions.
Capitation income streams are contracts capitated by the healthcare insurance companies and
the medical providers. They are usually pre-arranged fixed monthly payments received by the
physicians, hospital or clinics enrolled in the per capita. Fee- for-service is the most
traditional stream of income where the service providers are paid by the agencies of
government and insurance companies based on the number of services provided or the
number of procedures performed. The most appropriate stream of income for the healthcare
service providers is the capitation method because; it does not dilute the quality of service, it
is predictable, easier and cost effective.
Use of epidemiology
Epidemiology is the method used to find the outcomes of healthcare and diseases in
the population. It uses observational studies to learn about the causes of various diseases in

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Running Head: HEALTHCARE Healthcare Student Name Institution Date 1 HEALTHCARE 2 Reimbursement Maxcare is a for-profit private owned hospital. It is an exclusive approved hospital that provides quality healthcare services to the patients. For an organization to maintain its financial sustainability, it must use the right and most suitable type of reimbursement. In healthcare there are both traditional reimbursement models and the modern reimbursement models. The traditional models are cumbersome and costly and they are capitation and Fee for Service (FFS) Payments methods. Maxcare uses the modern reimbursement method commonly referred to as value-based reimbursement that focus on quality health service and the service providers using this model are rewarded based on the health outcome of the patient. This method is less costly and gives best quality service to the patients hence enhancing sustainability of the hospital (Loblova, 2020). Out- of- pockets are the direct individual payments to the healthcare providers at the time of the use of service and they majorly serve to sustain healthcare service provisions. Capitation income streams are contracts capitated by the healthca ...
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