Medicare, Medicaid, and the Delivery System Case Study

Medicare, Medicaid, and the Delivery System - Case Study ExampleAll these approaches deport incentives that seem to motivate a certain trend (Guterman, Davis, Schoenbaum & Shih, w238).However, of the above three, the fee-for-service is the traditional one. The capitation approach is up-to-date and is meant to be a step up concerning creating better incentives for preventive care, efficiency, and cost control in health care. down the stairs this payment system, a hospital, a physician, or a medical group receives a given politic fee per month for caring for a patient registered in a managed health care invention, notwithstanding the cost of the patients care. In the global capitation mode, whole networks of physicians and hospitals band in unison to take in single fixed per-month payments for registered health plan individuals. The providers sign one contract with a health plan covering the care group signatories, and then they must establish a way of dividing the capitated che ck among the members. flexibility in shared savings symbolizes a major feature of the proposed Medicare ACO rule. As such, even though ACOs go away be reimbursed by fee-for-services, CMS are also scheduled to come up with benchmarks designed towards every individual ACO. In case the ACO exceeds its specified standard in Medicare cost savings, it definitely qualifies for shared savings. However, it will as well be held accountable for any incurred losses for failing to meet the set benchmarks. In addition, CMS has proposed creating a minimum sharing rate meant to account for normal differences in expenditure that could determine whether ACO reaches or goes beyond its benchmark (Guterman, Davis, Schoenbaum & Shih, w250).In the proposed rules, CMS has set forth two tracks for ACO reimbursement models. Here, ACOs will be asked to serve at least five thousand Medicare beneficiaries for a period of 3years. This new rule gives ACO an opportunity to follow a nonreversible risk approach, w here only