Which description matches population-based payments?

Which description matches population-based payments?

• A. Population based payments
• B. One-sided risk
• C. Two-sided risk
• D. Fee-for-service

Answer: (A)

Population-based payments describe a model where a defined population is covered by a single fixed payment for a period, intended to cover most or all medically necessary care for that group. This shifts the focus from paying for individual services to managing the total cost and quality of care for everyone in the population. The arrangement can include risk-sharing, with providers bearing upside-only risk (one-sided) or both upside and downside (two-sided). This contrasts with fee-for-service, which pays for each service separately and is not population-based.

Population-based payments describe a model where a defined population is covered by a single fixed payment for a period, intended to cover most or all medically necessary care for that group. This shifts the focus from paying for individual services to managing the total cost and quality of care for everyone in the population. The arrangement can include risk-sharing, with providers bearing upside-only risk (one-sided) or both upside and downside (two-sided). This contrasts with fee-for-service, which pays for each service separately and is not population-based.