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Related Experiment Videos

Slicing the pie.

J D Standish1

  • 1Cardiovascular Division, University of Virginia, Charlottesville 22908, USA.

Medical Group Management Journal
|August 5, 1996
PubMed
Summary
This summary is machine-generated.

Floating conversion factor reimbursement offers a transparent and simple method for providers managing case rate contracts. This approach directly reflects plan performance to physicians, simplifying payment distribution challenges.

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Area of Science:

  • Healthcare economics
  • Medical billing and reimbursement

Background:

  • Case rate contracts shift payment division responsibility from insurers to providers.
  • Providers face challenges in managing payment distribution under these contracts.

Purpose of the Study:

  • To introduce and evaluate the floating conversion factor reimbursement method.
  • To highlight its advantages in managing case rate contracts.

Main Methods:

  • The study focuses on the floating conversion factor reimbursement method.
  • It emphasizes simplicity, transparency, and direct market reality feedback.

Main Results:

  • The floating conversion factor method is simple and transparent.
  • It provides direct insight into plan performance for physicians.

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  • Additional features like withholds are deemed unnecessary, and profit/loss sharing with hospitals can enhance incentive alignment.

    • Conclusions:

    • The floating conversion factor method is a advantageous approach for providers under case rate contracts.
    • It simplifies complex payment dynamics and aligns incentives effectively.