Health care workers are compensated for their services through various means. The commonly used methods for calculating the expected amounts are fee for service (FFS) and capitation. Any of the system which is adopted strives to provide the best health care services to members of the public.
Fee for service program is a traditional method of payment. The amount paid to a patient is determined by the nature of services being rendered to the individual. In cases where more services are rendered to a patient, they end up paying extra costs. The compensation for the services may be done by the individual, insurance company or a government program. This program dictates for a specific amount to be paid for services rendered as opposed to retainer, a salary or any other contractual agreements. This program provides patients with complete care which is advantageous to their wellbeing. Also, the physicians benefit for they have the clinical autonomy to charge their services without any restrictions (Williams 2008).
Fee for service is mainly used for physician remunerations after offering a service to a patient. However, it is accused of giving the physician an incentive for him or her to provide minimum care to an affected patient. Provision of poor services will allow the professional to see more patients within a short span of time. The more the patients, the higher the expected pay from rendering the services. The services can be expensive for patients to pay for since the physician has the autonomy to charge any costs. Through this program, the administration is extremely complex and inflexible. Therefore, it is difficult to adapt to changes in the working environment.
In capitation, a specific amount is paid to health workers periodically regardless of the quantity of services they have rendered to the patients. Each professional is paid a fixed amount for every patient they have served. In this, they do not consider the number of services you have provided or nature delivered. A fixed amount of compensation may also be provided depending on the time span that one has delivered the services like a year or a month (Shi, 2010)
The amount to be paid to the health provider depends on sex, age and even the area of residence of the patient. In this program, the compensation is usually calculated in advance which may depend on population and regardless of the health condition of the patient. This program removes the incentive of treating more patients as in the case of fee for service program. This program enhances better service provision to patients as the profit motive from medical practitioners is almost eliminated. Profit making motive is no longer the driving factor but a better service provision to patients (Williams, 2008). At the same time, this may encourage the health providers to include healthy people into their patient files who do not need any care. This will help in boosting the level of gains even though it is against the law. The health providers will be compensated the same amount for patients who need either minimum or maximum care. Neglect is evident to those who need maximum care and majorly focus on those who need minimum care to increase the number of patients one is attending. Both scenarios of capitation and fee for the service offer different cash flows to the economy. Capitation offers a fixed amount of compensation based on the number of members and regardless of the number of visits while fee for service is different since the amount is based on the number of visits (Wurman, 2004).
The US health care system is considered the best health care service providers in the world due to the availability of improved technologies and facilities. The system has both private and public insurers to cater for the poor and low income earners. The main way of private insurers is through employer sponsored insurance covers provided privately.
Public health insurance c
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