Commercial insurance plans usually reimburse health care providers under some type of __________ payment system, whereas the federal Medicare program uses some type of ___________ payment system.

Question

Quizplus · Accepted Answer

Commercial insurance plans usually reimburse health care providers after the care has been provided, using a retrospective payment system. They pay based on the actual services provided and the fees charged by the provider. On the other hand, Medicare uses a prospective payment system, where payment is determined in advance based on a predetermined fee schedule for a particular service or procedure. This incentivizes providers to deliver care more efficiently and avoid unnecessary procedures or services. Therefore, option C is the correct answer.

Commercial Insurance Plans Usually Reimburse Health Care Providers Under Some