The Urban Institute has issued two new papers with background information on health care payment methodologies and the design of health care benefits packages.
The first paper, Payment Methods: How They Work, describes nine payment methodologies:
- fee schedules
- primary care capitation
- per diem payments to hospitals for inpatient visits
- DRG-based payments to hospitals for inpatient visits
- global budgeting for hospitals
- bundled payments
- global capitation for organizations
- shared savings
- pay for performance
The second paper, Benefit Designs: How They Work, explains seven different types of benefit designs:
- value-based design
- high-deductible health plans
- tiered networks
- narrow networks
- reference pricing
- centers of excellence
- benefit design for alternative sites of care
A third paper, Matching Payment Methods with Benefit Designs to Support Delivery Reforms, describes how to match benefit designs with payment methods.
Go here to find Payment Methods: How They Work.
Go here to find Benefit Designs: How They Work.
And go here to find Matching Payment Methods with Benefit Designs to Support Delivery Reforms.
