Health & Medical Question

Payments for Health Services Providers

Insurance is based on pooling of losses, payment for random losses, risk transfer, and indemnification. As a result, insurers use several different approaches to mitigate their risk and set premium rates, including:

the fee-for-service method

the cost-plus approach

population health – capitation

Describe advantages and disadvantages of each system.

Identify how pay for performance can be added to each payment system.

Name
CT_Rubric_100
Description
100 Points
Rubric Detail
Levels of Achievement
Criteria
Exceeds Expectation
Meets Expectation
Some Expectations
Unsatisfactory
Content
33 to 35 points
29 to 32 points
26 to 28 points
0 to 25 points
Demonstrates
substantial and
extensive knowledge of
the materials, with no
errors or major
omissions.
Demonstrates adequate
knowledge of the
materials; may include
some minor errors or
omissions.
Demonstrates fair
knowledge of the materials
and/or includes some
major errors or omissions.
Fails to demonstrate
knowledge of the
materials and/or
includes many major
errors or omissions.
33 to 35 points
29 to 32 points
26 to 28 points
0 to 25 points
Provides strong thought,
insight, and analysis of
concepts and
applications.
Provides adequate
thought, insight, and
analysis of concepts and
applications.
Provides poor though,
insight, and analysis of
concepts and applications.
Provides little or no
thought, insight, and
analysis of concepts and
applications.
15 to 15 points
13 to 14 points
11 to 12 points
0 to 10 points
Sources go above and
beyond required criteria
and are well chosen to
provide effective
substance and
perspectives on the
issue under
examination.
Sources meet required
criteria and are
adequately chosen to
provide substance and
perspectives on the issue
under examination.
Sources meet required
criteria but are poorly
chosen to provide
substance and perspectives
on the issue under
examination.
Source selection and
integration of knowledge
from the course is clearly
deficient.
15 to 15 points
13 to 14 points
11 to 12 points
0 to 10 points
Project is clearly
organized, well written,
and in proper format as
outlined in the
assignment. Strong
sentence and paragraph
structure, contains no
errors in grammar,
spelling, APA style, or
APA citations and
references.
Project is fairly well
organized and written
and is in proper format as
outlined in the
assignment. Reasonably
good sentence and
paragraph structure, may
include a few minor
errors in grammar,
spelling, APA style, or APA
citations and references.
Project is poorly organized
and written and may not
follow proper format as
outlined in the assignment.
Inconsistent to inadequate
sentence and paragraph
development, and/or
includes numerous or
major errors in grammar,
spelling, APA style or APA
citations and references.
Project is not organized
or well written and is not
in proper format as
outlined in the
assignment. Poor quality
work; unacceptable in
terms of grammar,
spelling, APA style, and
APA citations and
references.
Analysis
Sources
Demonstrates
college-level
proficiency in
organization,
grammar and
style.
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