Question

Describe three interrupted services provision used in the Medicare Hospital Outpatient payment System.

Answer 1

Service provision in the Medicare Hospital Outpatient payment System can be interrupted by capitated payments.

Three interrupted services provision used in the Medicare Hospital Outpatient payment System are: Adverse selection, Moral hazard, Managed care.

Step-by-step explanation:

Three interrupted services provision used in the Medicare Hospital Outpatient payment System are:

1. Adverse selection: This occurs when insurance buyers have more information about the risks they face than the insurance company. It can result in low-risk parties avoiding insurance and high-risk parties embracing it.
2. Moral hazard: In a fee-for-service system, medical care providers are paid based on the services they provide, which can create a moral hazard where providers may overutilize services to increase their payment. This is mitigated in health maintenance organizations where providers receive a fixed payment per person enrolled.
3. Managed care: This is a system of healthcare organization that aims to manage costs and improve quality through negotiated contracts with healthcare providers. It is commonly used in health maintenance organizations.