“Capitation, Payers, and Provider Behavior”  Please respond to the following:

  • Suggest at least one (1) method by which capitation rates are set for health maintenance organizations in Medicare. Provide one (1) example of an HMO with these types of set rates in order to support your response.
  • Compare the primary available economic resources that health insurance payers may use to monitor, assess, and regulate health care providers’ behavior. Evaluate the degree to which alternative provider payment methods (e.g., capitation, pay for performance, etc.) impact HMO economic and business performance. Provide one (1) example of such a type of method to support your response.

 

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