What payment system pays health care providers for each service performed?

Study for the Louisiana Series 103 – Life, Health, and Accident or Sickness Insurance Exam. Familiarize yourself with key concepts through engaging questions and explanations. Prepare effectively for your exam!

Multiple Choice

What payment system pays health care providers for each service performed?

Explanation:
Paying for health care per service performed is a fee-for-service model. In this system, each distinct service—an office visit, a lab test, an imaging study, or a procedure—gets tied to a separate payment. The provider’s reimbursement increases with the number and type of services delivered, so the payer tends to pay for every billed service. In contrast, salary-based payments give a fixed regular income regardless of how many services are provided; capitation pays a set amount per patient for a period, independent of the exact number of services used; and a block grant is a lump-sum funding to an organization for a defined purpose, not tied to individual services.

Paying for health care per service performed is a fee-for-service model. In this system, each distinct service—an office visit, a lab test, an imaging study, or a procedure—gets tied to a separate payment. The provider’s reimbursement increases with the number and type of services delivered, so the payer tends to pay for every billed service.

In contrast, salary-based payments give a fixed regular income regardless of how many services are provided; capitation pays a set amount per patient for a period, independent of the exact number of services used; and a block grant is a lump-sum funding to an organization for a defined purpose, not tied to individual services.

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