A. Monetary Valuation
The analysis estimates that the following benefits are worth $200 billion:
• Direct medical costs averted
• Valuation of quality of life gained due to non-fatal heart attacks averted
• Valuation of life years gained due to fatal heart attacks averted
Next, the analysis estimates that cost to the industry and consumers is $17 billion.
1. Calculate the net benefits. 200-17=183
2. What does the value tell you as an administrator relative to the benefit of the procedure?
Part B. Reimbursement Methods
Answer the following questions:
• What are the various reimbursement methods used by third-party payers?
a. FEE FOR SERVICE
b. CHARGE-BASED REIMBERSEMENT
c. PERSPECTIVE PAYMENT
d. CAPTATION
e. OUT OF POCKET
• What incentives are given to providers under each of these reimbursement protocols?
a. CAN BE POSITIVE OR NEGATIVE-DISCUSS PROS AND CONS-EFFECTS ON PATIENTS VS PROVIDERS
• How do these reimbursement methods impact the delivery of health services?
b. CAN BE POSITIVE OR NEGATIVE-DISCUSS PROS AND CONS-EFFECTS ON PATIENTS VS PROVIDERS
• What is capitation?
a. DISCUSS WITH DETAILS-PROS & CONS- COMPARE & CONTRAST TO 1 OTHER METHOD
• What are the advantages and disadvantages of each of these reimbursement methods?
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