The insurer will be limited by what the consumer can afford to pay for health insurance. Managers of the health care delivery system must know the per capita cost of providing care to the insured population and compare that cost to what the insurer is being paid per capita per month. DEVELOPMENT OF A CAPITATION PAYMENT RATE ? Determine Delivery System Cost Base for Targeted Population o The first step in determining the capitation rate is to predict the costs of providing care to the insurer's population, based on assumptions about the population and on the cost structure of the delivery system...
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Information from a cost accounting system is necessary for this step. Accurate cost data should be figured by service and should be broken out into the components of fixed and variable costs. Using this method, inpatient service lines are defined by grouping diagnosis-related groups (DRGs) into 16 categories...
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Universal Healthcare Should the United States adopt a Universal Health coverage system? Germany, the Netherlands, Japan, and in the United States Hawaii, all use a system of health care that is universal, comprehensive, and private...	1 / 169
Health Care Reform As Theda Skocpol says "?debt and disillusionment with the federal government were growing before the 1980s. But the republican ascendancy of that decade exploded the deficit and deliberately encouraged cynicism about public efforts to address national problems...	3 / 719
Health Care Reform Obama will require that health care providers participate in what he calls the “Federal Employee Health Care Benefits Program1” (FEHBP). Obama states that by doing so, it will not only give doctors better information but it will also improve the quality of the health care provided...	3 / 601
Healthcare Policy The relative emphasis on each issue varies over time, with quality at times being seen as a most critical issue and concerns about rising costs dominating public discussions of health care at other points...	2 / 311