Match the health care model with the correct description.
Understand the Problem
The question is asking to match different healthcare models with their correct descriptions. This requires understanding and knowledge about various healthcare models and their features.
Answer
Managed care controls costs; HMO requires referrals; Capitation is based on payments per member; PPO offers specialist access without referrals.
Managed care is a system of health care delivery that aims to control costs and improve quality. HMO is a plan that requires referrals to specialists, as well as precertification and preauthorization for hospital admissions, outpatient procedures, and treatments. Capitation involves patients being assigned a per-member, per-month payment based on age, race, sex, lifestyle, medical history, and benefit design. PPO allows an insured person to go directly to a specialist without referrals.
Answer for screen readers
Managed care is a system of health care delivery that aims to control costs and improve quality. HMO is a plan that requires referrals to specialists, as well as precertification and preauthorization for hospital admissions, outpatient procedures, and treatments. Capitation involves patients being assigned a per-member, per-month payment based on age, race, sex, lifestyle, medical history, and benefit design. PPO allows an insured person to go directly to a specialist without referrals.
More Information
These models influence how healthcare services are delivered, impacting patient access and provider reimbursement.
Tips
Ensure you know the distinct features of each healthcare model to avoid confusion.
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