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1 :

Hint : ๐Ÿ“† One flat rate per client.

Correct Answers:

  • The provider is paid a fixed sum for the client on a monthly or yearly basis.


Rationale :

๐Ÿ’ณ In a Health Maintenance Organization (HMO), providers are typically reimbursed through a capitation model, meaning they receive a fixed payment per member per month or year, regardless of how many services that client actually uses.

๐Ÿ’ณ This prepaid payment structure incentivizes providers to focus on preventive care and cost-efficiency, since their reimbursement is not tied to the volume of services rendered.

๐Ÿ’ณ The model allows for budget predictability and encourages coordination of care, especially through primary care providers who serve as gatekeepers to specialized services.

๐Ÿ’ณ This system contrasts sharply with fee-for-service models, where providers are paid for each individual service or procedure, often leading to increased healthcare costs and fragmented care.


Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

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