The CEO of Cardiology Associates has been approached by a Vice President of Alpha Health Plans to accept a capitation arrangement for all professional services associated with enrollees in Alpha’s local market area. Currently, Cardiology Associates is being paid on a resource based relative value scale (RBRVS) fee schedule that gives them 110% of current Medicare rates. Alpha Health Plan wants Cardiology Associates to accept a capitation payment of $10.50 per month for every enrollee in Cardiology Associates’ market area. Cardiology Associates is not certain whether all of the VP’s claims of the benefits of this new method are true.

Let’s explore which method is better, and for whom.

Share your ideas with your classmates about the shift of so many procedures from inpatient to outpatient.

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