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Under a discount on charge arrangement, the provider receives

A) a flat fee.
B) more than what it would normally charge for a particular service.
C) less than what it would normally charge for a particular service.
D) an amount equal to the charge for the service.

1 Answer

3 votes

Final answer:

Under a discount on charge arrangement, the provider receives less than what it would normally charge for a particular service. This is often contrasted with a fee-for-service system, which reimburses providers based on the individual services provided. Adverse selection can affect these dynamics in the insurance market.

Step-by-step explanation:

Under a discount on charge arrangement, the provider receives less than what it would normally charge for a particular service. This is a common method where providers give a discounted rate to insurers or health maintenance organizations (HMOs) in exchange for a steady stream of patients or inclusion in the insurer's network. For instance, in a fee-for-service system, the healthcare provider is reimbursed for each service provided to a patient. In contrast, HMOs typically operate on a capitation basis, where they receive a set amount per enrolled person assigned to them per period, regardless of whether that person seeks care.

Adverse selection is a phenomenon in the insurance industry where there is a mismatch in information between the insurance buyers and the insurance company. High-risk parties are more likely to engage with the insurance offerings as it benefits them more, while low-risk parties may opt out due to cost considerations—leading to a potential imbalance in the insurance pool.

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