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Which of the following is not a fee-for-service reimbursement methodology? A. Charge-based reimbursement B. Bundled payment C. Per diem D. Capitation

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Final answer:

Capitation is not a fee-for-service reimbursement methodology as it involves payment to providers based on the number of patients they handle, unlike charge-based reimbursement, bundled payment, or per diem which are all linked to services provided.

Step-by-step explanation:

The question at hand asks which option is not a fee-for-service reimbursement methodology. In a fee-for-service (FFS) model, health care providers are reimbursed for each service, such as a test or procedure, that they provide to patients. Comparing the options given:

  • Charge-based reimbursement is a type of FFS where providers are paid based on the charges they set for services.
  • Bundled payment is not a FFS model. Instead, it involves a single, comprehensive payment for all services related to a specific treatment or condition over a defined period.
  • Per diem reimbursement provides a daily flat rate to providers for services regardless of the number or type of services provided in a day.
  • Capitation is a payment arrangement where providers are paid a set amount per patient regardless of how many services the patient receives, which is also not a fee-for-service model.

Therefore, Bundled payment and Capitation are not FFS reimbursement methodologies. Specifically, Capitation stands out as the option most distinct from fee-for-service since it is based on the number of patients rather than individual services rendered.

User Shankar Shastri
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