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Alexa Belleau

RE: Discussion – Week 4

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Fee for Service vs Cash-Based Payments

The fee for service payment method is when “the provider of services is paid according to the service performed” (Baker, Baker, &

Dworkin, 2018, p.g. 38). An example of this is if you go to the Emergency Room. You are billed separately for lab, imaging and

physicians. Cash based payments are when you pay for the service upfront. After this you may seek reimbursement from your insurance

company. For example, a specialty provider such as a chiropractor. You would pay at each visit but then ask for reimbursement from

insurance.

Health Care Payment System

There are two alternative reimbursement strategies involved in “Which Health care Payment System is Best.” They are the episode

payment and comprehensive care payment. The episode payment method is “paying a single price for all of the healthcare services

needed by a patient for an entire episode of care” (Center for Healthcare, n.d.). The comprehensive care payment method is “paying a

single price for all of the services needed by a specific group of people for a fixed period of time” (Center for Healthcare, n.d.). This

payment method decreases the number of episodes with certain chronic conditions.

Nurse to Patient Ratio

The payment and revenue of clinics and hospitals can be affected by nurse to patient ratios (Moore & Waters, 2012). The more revenue

a medical facility receives the more staff they can hire to take care of their patients. With lower ratios patients will receive better care

because they have more one on one time with their patients.

References

Baker, J. J., Baker, R. W., & Dworkin, N. R. (2018). Health Care Finance: Basic Tools for Nonfinancial Managers (5th ed.). Burlington, MA: Jones and Bartlett Learning.

Center for Healthcare Quality and Payment Reform. (n.d.). Which health care payment system is best? Retrieved from http://www.chqpr.org/downloads/WhichPaymentSystemisBest.pdf

Moore, A., & Waters, A. (2012). Getting ratios right, for the patients’ sake. Nursing Standard, 26(31), 16–19. Retrieved from: https://eds-a-ebscohost-com.ezp.waldenulibrary.org…

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