https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g Made with a curious mind en-us 2022-01-16 18:54:59 UTC 2026-03-19 12:58:31 UTC hello@padlet.com joannetreb https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/1994787054 Capitation is a specified amount of money paid to a healthcare plan or physician to cover the cost of a healthcare plan member's services for a certain length of time.

I understand the concept of this approach but it was the one that I had the most questions about it so I chose this one.

This reimbursement gets agreed upon and the money is set aside for this individual and their medical needs.  

My first question is:  What happens when this individual has a complication and either needs to stay in hospital longer or they need to have a more serious procedure due to complication that was not forseen?  

My second question is:  Does the amount of money then get adjusted and more approved or does the amount stay the same and the patient then needs to foot the extra money?

My third question is:  What happens when the plan is in progress and the cost for a procedure or supplies goes up?  How do they know how to project the cost of providing services?

Joanne


]]> 2022-01-16 23:25:30 UTC https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/1994787054 angiesgizzie https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/1997016348 This type of reimbursement is also a incentive to healthcare providers to improve clinical performance using the EHR. If they do this it can result in additional reimbursement or grant eligibility. I understand that the goal is to improve quality, efficiency, and the overall value of healthcare, but I where I am confused is how this is not essentially a legal bribe? I mean is it not a little unethical? I understand that this sounds like a great opportunity to improve care for patients, but those in the healthcare industry should want that too without having to make extra funds. I understand that this option is a good one in the way that it generates more money for the care setting, which in turn mean they can make improvements to care, the facilities, equipment, etc. A question I have is how do they ensure all care settings are lacking on integrity and use this system to there advantage? Or if that is even a possibility?]]> 2022-01-18 04:15:22 UTC https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/1997016348 joannetreb https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/2010087411 Is there anything else that we want to talk about in this Padlet?  Not sure what happened to Heidi but she did say that she would post something but have not heard from her in a couple of days.  Let me know your thoughts.  I will check back on here Tuesday morning.

]]> 2022-01-25 01:27:21 UTC https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/2010087411 https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/2012432521 Episode-of-Care Reimbursement is given for ongoing medical treatment by a healthcare professional for a certain clinical problem. It is a flat fee for all services for that treatment. If complications arise, additional fees are charged. One question I have is, how is it different from Fee-For Service? In Fee-For-Service, the patient is billed for individual services after-the-fact. In Episode-of-Care, the company has to figure out how much it costs to provide the individual services and the patient's fee is established before the care is provided. Secondly, is there a way to know if these 2 methods actually result in that much difference in reimbursement over the course of treatment? Another question I have is how is the level of fees charged for each complication that may arise?]]> 2022-01-26 00:27:21 UTC https://padlet.com/joannetreb/qdtpr7dxj3pcfd9g/wish/2012432521