What is a lump-sum payment distributed among physicians and facilities known as?

What is a lump-sum payment distributed among physicians and facilities known as?

• A. Capitation.
• B. Fee-for-service.
• C. A prospective payment system.
• D. A global payment.

Answer: (D)

A lump-sum payment distributed among physicians and facilities is referred to as a global payment. This payment structure is designed to cover a group of services related to a specific treatment or condition over a defined period, rather than billing separately for each service or encounter. The concept of global payment encourages care coordination and efficiency since providers receive a single payment for all services provided to a patient, thus promoting a more holistic approach to patient care. This system supports a focus on quality and outcomes instead of the volume of services rendered, aligning financial incentives with patient health needs. In contrast, capitation involves paying a fixed amount per enrolled patient per unit of time, typically for primary care services rather than a lump-sum for multiple providers or services. The fee-for-service approach compensates providers for each service rendered, resulting in costs that can accumulate quickly and might not incentivize coordinated care. A prospective payment system typically refers to predetermined payments based on diagnosis-related groups (DRGs) for hospital stays, rather than a lump sum for a range of services across multiple providers. Thus, the global payment model distinctly captures the idea of distributing a single lump-sum payment across various entities involved in providing comprehensive care.

A lump-sum payment distributed among physicians and facilities is referred to as a global payment. This payment structure is designed to cover a group of services related to a specific treatment or condition over a defined period, rather than billing separately for each service or encounter.

The concept of global payment encourages care coordination and efficiency since providers receive a single payment for all services provided to a patient, thus promoting a more holistic approach to patient care. This system supports a focus on quality and outcomes instead of the volume of services rendered, aligning financial incentives with patient health needs.

In contrast, capitation involves paying a fixed amount per enrolled patient per unit of time, typically for primary care services rather than a lump-sum for multiple providers or services. The fee-for-service approach compensates providers for each service rendered, resulting in costs that can accumulate quickly and might not incentivize coordinated care. A prospective payment system typically refers to predetermined payments based on diagnosis-related groups (DRGs) for hospital stays, rather than a lump sum for a range of services across multiple providers. Thus, the global payment model distinctly captures the idea of distributing a single lump-sum payment across various entities involved in providing comprehensive care.