Capella University
Health Care Reimbursement Systems Reimbursement Models
March 20, 2024
TO: Troy Holland, Director of Patient Services
REIMBURSEMENT MODELS2 FROM: SUBJECT: Case # 1149923 Traditional Reimbursement Models Characteristics of a fee-for-service reimbursement model reveals a form of compensation where physicians and healthcare providers are rewarded by insurance companies based on the number of services they offer, including tests, procedures, and treatments rather than the quality of service.
To monitor quality under this model, federal regulations enacted the formation of Access Monitoring Review Plans (AMRPs) as part of the Social Security Act. AMRP provide states the latitude it needs to access data, conduct investigations on provider practices to ensure patients are receiving appropriate quality of care, and standards are being kept (LaPointe, 2016). New Reimbursement Models Value based payment model is an alternative reimbursement method to the fee for service
