Fee-For-Service Payment in Health Insurance

This video explains fee-for-service payment between doctors and insurers.

[IttyBittydelivery]

Thank you for showing and your clear briefing description are very effective ❣️

[MicahErfan]

Just wanna say, your channel is incredibly underrated! Your videos cover topics that are so extremely important, but often lesser understood, in a manner that is concise and easy to follow. Thanks so much for doing what you do.

[ajkovic]

Thank you so much. You deserve million viewers. U made this very simple and understandable

[junesilvermanb]

Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.

In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than the quality of care.

However, evidence of the effectiveness of FFS in improving health care quality is mixed, without conclusive proof that these programs either succeed or fail.

Similarly, when patients are shielded from paying (cost-sharing) by health insurance coverage, they are incentivized to welcome any medical service that might do some good.

Fee-for-services raises costs, and discourages the efficiencies of integrated care.

A variety of reform efforts have been attempted, recommended, or initiated to reduce its influence (such as moving towards bundled payments and capitation).

In capitation, physicians are not incentivized to perform procedures, including necessary ones, because they are not paid anything extra for performing them.

FFS is the dominant physician payment method in the United States.

In the Japanese health care system, FFS is mixed with a nationwide price setting mechanism (all-payer rate setting) to control costs.

[ajkovic]

Plz make video about bundle payment as wwll

[The-Spondy-School]

Your idea of capitation is fuzzy. Insurance companies rake in capitatoon payments of over $1100 every month on seniors whether they see doctors or not. If you need actual services the cost of servive is NOT deducted from the capitation slush fund. It is paid over and above the capitation -- which turms out to be essentially free money. If the doctor can make a claim that you are high risk for anything -- they can receive thousans more in free money as high risk assessment slush fund. Medicare has lots of benefits, but overall, it's a royal screwing for the American public.