Health Insurance

Overview

• Medicare and Medicaid 
• Federal social insurance programs
  • were created as part of the Social Security Act
• Medicare 
  • Covers the elderly (65+ years)
  • Also covers ESRD
  • 2 main parts 
    • Part A pays the hospital
    • Part B pays physicians
    • Part C are all-in-one plans
    • Part D provides prescription drug benefits
• Medicaid
  • For low income people
• Federal and state components

Physician Compensation

• Capitation
  • fixed amount of money per patient per unit of time over which services are rendered
• Fee-for-service  
  • physician is paid separately for each service rendered
• Salary
  • fixed amount of money paid physician irrespective of services rendered