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It can be postulated that there are two scenarios when

May 6, 2022

It can be postulated that there are two scenarios when it comes to price setting by providers and provider organizations. Providers refer to those practitioners eligible to bill third-party payers for the services they provide to patients. Provider organizations are facilities where care is delivered to patients. The first scenario is that providers and provider organizations are considered “price takers,” in that the rates of reimbursement are set by the payers with little to no input from providers and organizations. The second scenario is that providers and organizations set their own prices and that payers are expected to pay these rates. These strategies will be explored in this week’s discussion assignment.

Briefly discuss what is meant to be a price setter or price taker, the strategies employed in both approaches, and a clear listing of the pros and cons associated with each price setting strategy. After weighing the pros and cons of each, which approach do you feel best meets the needs of the key stakeholders?

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