Understanding traditional emerging reimbursement models

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Thank you for submitting assessment #2. I can see that you’ve put some thought into this submission and you covered most of the main points based on the assessment criteria. I’ve enjoyed reading your submsion that includes 3-5 pages on the various reimbursement options that a large primary care office would have for the charges associated with a new patient consult.

However, I do see that there are some errors in this assessment, for improvement. Please see each criteria below with specific feedback, suggestions/considerations. Also, attached is the grading rubric/scoring guide with specific feedback/comments.

If you decide to resubmit assessment #2 make sure you highlight what did you do different on the 2nd submission (i.e. additions and changes made, etc.). Also, note on the document what criteria (criterion 1,2,3,4,5, etc.) you want reevaluated and what substance added shows that you have met the criteria.

As you progress in FlexPath, I hope that you will consider incorporating faculty feedback on one assessment, before you submit a new assessment for evaluation. Incorporating faculty feedback into each new assessment, will save you time and energy, and may positively influence performance scores. You have the potential to be an excellent writer.

I am looking forward to reviewing your next assignment/assessment submission. If you have any questions or concerns do not hesitate to contact me.


I rarely see a detailed compare and contrast on how quality outcomes are rewarded under traditional and current payment methodologies in health care.Consider adding additional information about the integrated delivery system; which is a network of organizations that provides or arranges to provide a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the outcomes and health status of the population within its geographic service area. I am noticing that this is becoming more of a trend when it comes to quality outcomes.

Add a section within your submission that fully explains reasoning for newer models of reimbursement in health care.For example; adding an explanation of the main models for organizing PPO/HMO reimbursements. Provide a discussion on the advantages and disadvantages of main models.

I do not see any current trends noted. For this section consider adding verbiage on current trends. For example; industries operating contract practice plans either hired physicians on salary or contracted with independent physicians and hospitals at a flat capitated rate per worker per month. These features are found in certain managed care plans today. Prepaid group practice also provided comprehensive services for a capitated fee. Later, health maintenance organizations were modeled after prepaid health plans. Managed care organizations today attempt to combine the efficiencies of contract and group arrangements with the objective of delivering comprehensive healthcare services at predetermined costs.


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