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2.1 Briefly explain the following characteristics of insurance: a. Pooling

October 29, 2021

2.1 Briefly explain the following characteristics of insurance:

a. Pooling of losses

b. Payment only for random losses

c. Risk transfer

d. Indemnification

2.5 a. What are the primary characteristics of managed care plans?

b. Describe different types of managed care plans.

2.7 Describe the provider incentives under each of the following reimbursement methods:

a. Cost based

b. Charge based (including discounted charges)

c. Per procedure

d. Per diagnosis

e. Per diem

f. Bundled payment

g. Capitation

2.10 What are some features of the ACA that affect healthcare insurance and reimbursement?

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