Question

a reimbursement methodology that increases payment if health care service fees increase is known as
a. fee - for - service.
b. physician incentive.
c. sub - capitation payment.
d. capitation.

Explanation:

• Fee - for - service (a): In this model, healthcare providers are paid for each individual service they render. So, if more services are provided, the payment increases. For example, a doctor is paid for each consultation, test ordered, or procedure done.
• Physician incentive (b): This is more about motivating physicians through bonuses or other non - service - based rewards (e.g., for meeting certain quality metrics), not directly increasing payment based on the volume of services.
• Sub - capitation payment (c): This is a form of payment within a capitated (fixed amount per patient) system where a portion of the capitation is paid to a sub - entity (like a specialist within a network), and it is not based on increasing service - based fees.
• Capitation (d): Here, providers are paid a fixed amount per patient (enrollee) over a period (e.g., per month), regardless of the number of services provided. So, it does not increase payment as service fees increase.

Answer:

A. fee - for - service