Discuss Capitation and evaluate if either program reimburses using a capitation model.
Assess the differences in benefits and costs, which are available to Medicare patients based upon the patent selecting either the “Traditional” Medicare program or Medicare Part C (Advantage Plan). Once a patient makes a choice, is he or she locked into the choice?
• Evaluated at least two valuable elements to both programs and two negative elements to both programs.
• Demonstrate which program would be more attractive to a physician and to a hospital as well as why.
• Discuss Capitation and evaluate if either program reimburses using a capitation model.
Resources: Use these and others from the library.
Berenson, R. A., Sunshine, J. H., Helms, D., & Lawton, E. (2015). Why medicare advantage plans pay hospitals traditional medicare prices. Health Affairs, 34(8), 1289-1295. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1377/hlthaff.2014.142
Afendulis CC, Landrum MB, Chernew ME. The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment. Health services research. 2012;47(6):2339-2352. doi:10.1111/j.1475-6773.2012.01426.x.