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Healthcare Reimbursement Methodologies In Saudi Arabia Versus United States

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Health & Medical
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Saudi electronic university
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Healthcare Reimbursement Methodologies in Saudi Arabia Versus United States
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Introduction
When a care provider or institution presents a claim, it is referred to as reimbursement.
Then, depending on their arrangement, the insurance carrier or third-party administration
compensates the practitioner or institution for their claim (Morgan et al., 2013). In the health
sector, institution reimbursement is a major concern. Hospital competence is determined by
reimbursement schemes that are created over time. Because there are several changes in how
patients are hospitalized and readmitted to health facilities, payments must be adjusted accordingly
(Tao et al., 2016; Jaqua & Jaqua, 2019). These brief compares healthcare reimbursement
methodologies in Saudi Arabia with the United States. Further highlights the pros and cons of the
current reimbursement model in Saudi Arabia and the United States.
Current Healthcare Reimbursement Model in Saudi Arabia and United States
The Saudi Ministry of Health (MOH) is the country's major public healthcare institution,
providing more than 60% of hospital services. The cost of medical care, on the other hand, is
soaring way quicker than the economic growth, with many scholars believing that the primary
reason for the rapidly increasing cost of care in the two most essential elements (healthcare
facilities and medical professionals’ services) is the salary-based payment model, which is used to
reimburse medical facilities and care providers. In Saudi Arabia, the salary-based model is the
most extensively utilized method of compensating healthcare professionals. It is characterized as
a mechanism that pays healthcare providers a specific amount for a fixed period of time - which
may be a week, month, or year (AlRuthia et al., 2020).
In the United States, private payers play a significantly larger role in supporting health care
than they do in Saudi Arabia. The fee-for-service (FFS) reimbursement structure is the most

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1 Healthcare Reimbursement Methodologies in Saudi Arabia Versus United States Institution Affiliation Course Name Instructor Date 2 Introduction When a care provider or institution presents a claim, it is referred to as reimbursement. Then, depending on their arrangement, the insurance carrier or third-party administration compensates the practitioner or institution for their claim (Morgan et al., 2013). In the health sector, institution reimbursement is a major concern. Hospital competence is determined by reimbursement schemes that are created over time. Because there are several changes in how patients are hospitalized and readmitted to health facilities, payments must be adjusted accordingly (Tao et al., 2016; Jaqua & Jaqua, 2019). These brief compares healthcare reimbursement methodologies in Saudi Arabia with the United States. Further highlights the pros and cons of the current reimbursement model in Saudi Arabia and the United States. Current Healthcare Reimbursement Model in Saudi Arabia and United States The Saudi Ministry of Health (MOH) is the country's major public healthcare institution, providing more than 60% of hospital services. The cost of medical care, on the other hand, is soaring way quicker than the economic growth, with many scholars believing that the primary reason for the rapidly increasing cost of care in the two most essential elements (healthcare facilities and medical professionals’ services) is the salary-based payment model, which is use ...
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