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Capitation, Payers and Provider Behavior
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In the healthcare setting, different economic resources are significant and can be used by
health insurance payers to monitor, assess, and regulate the healthcare provider’s behavior. Some
common approaches that can be used in this case include concurrent management, preadmission
management, and review of post-hospital (Lynn, 1). Concurrent management is featured as an
approach of comparing when a patient gets the same services on the same date from more than
one physician in the same clinic or hospital. This is important as it is used to show if they
provided the same billing and information.
Secondly, preadmission management is another critical economic resource that can be
used. This is important as it is used for providing more information on the patient information
and if the …
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