Question

A health services coordinator accepted a new job at a primary care clinic that is paid a fixed, pre-arranged monthly fee per patient. Which value-based care model is being used by this clinic?

Answer 1

The clinic is using a Health Maintenance Organization (HMO) model, where healthcare providers are paid a fixed monthly fee per patient.

Step-by-step explanation:

The value-based care model being used by this primary care clinic is known as a Health Maintenance Organization (HMO).

HMOs provide healthcare services to patients for a fixed, pre-arranged monthly fee per patient, regardless of how many services are used. In this model, healthcare providers are incentivized to focus on the overall health and preventive care of patients to avoid unnecessary procedures and costs, as their revenue is not tied to the quantity of services rendered. This stands in contrast to the traditional fee-for-service model, where providers are compensated for each individual service they perform.

The shift from fee-for-service to HMOs aims to reduce the moral hazard problem by giving providers an interest in limiting overuse of healthcare services, provided that it does not lead to worse health outcomes. Many doctors now receive a hybrid of both managed care and fee-for-service payments, balancing flat rate per patient care with additional payments for treating specific conditions.