To control moral hazard and the increased spending that accompanies it, managed care providers include _______ in contracts with provders.

Question

Quizplus · Accepted Answer

Managed care providers use a combination of clinical rules, capitation, and risk sharing to control moral hazard and the spending that comes with it. Clinical rules are designed to ensure that patients receive appropriate care based on evidence-based guidelines. Capitation involves paying providers a fixed fee per patient, regardless of how much care they need. This creates an incentive for providers to keep patients healthy and to avoid unnecessary tests and procedures. Risk sharing involves providers and payers sharing financial risk, which can encourage providers to be more cost-effective and efficient in their care delivery. Therefore, all three options (A, B, and C) are commonly used in contracts with providers.

To Control Moral Hazard and the Increased Spending That Accompanies