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In the healthcare system, the price of any service or procedure is determined y the demand and supply of those services and procedures in the market.
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- Which method(s) of payment to physicians will most likely result in higher total charges due to volume of services provided? Capitation. Salary. Fee-for-service (FFS). RBRVs. Methods based on patient outcomes.What is the significance when it comes to cream skimming to show it's efficient function of a medical market?True or False. There is no such thing as “too much competition” in the private hospital market. Be sure to justify your answer.
- Should health care providers be expected to produce outcomes data to justify their charges? How are charges determined? What drives charges? (Be sure to differentiate between costs and charges) EXPLAIN IN DETAIL.How can healthcare systems address the inelastic demand for emergency care to prevent unchecked and exorbitant pricing for patients?True or false and explain State policies that mandated the release of physician report cards were greatly beneficial to consumers by allowing them to more efficiently search for high quality surgeons.
- The primary purpose of he Coordinalion of Benefits provision found in most group Major Medical policies is to perform which of the following funclions? A.Providing coverage for insureds who are leaving heir employment B.Preventing a claimant from profiting from an injury or sickness C.Allowing an insured to receive bolh Disability Income benefits and Medical Expense benefits if entilled o both D.Permitting an insurance company to pay benefits direclly to providers of medical servicesWhy would payers want to add shared savings components to PMPM or enhanced FFS payments to primary care clinicians?Indicate whether each statement is true or false, and justify your answer.Prospective payment systems align the interests of doctors and their patients.
- Explain Benefits and Flaws of Payback Screening?Indicate whether the statement is true or false, and justify your answer.Physicians have no say in what prices to charge their patients.An important distinction in health insurance is between the list price (PL) and out-of-pocket price (PP) of a medical good or service. The list price is the official price that the provider charges the insurance company, while the out-of-pocket price is the price that the insurance customer faces. Sometimes, the out-of-pocket price depends on the list price. d. Now assume the consumer is part of a partial insurance plan with a coinsurance provision. Her insurance pays 50% of all medical expenses. Consider again the relationship between PL and PP and plot a coinsurance plan demand curve in PL - Q space. Label this curve D3. e. Finally, assume the consumer is part of a partial insurance plan with a copayment provision. Her insurance pays all expenses above and beyond her copayment of $25 for each unit of Q. Consider again the relationship between PL and PP and plot a copayment-plan demand curve in PL - Q space. Label this curve D4.