Certified Nurse Manager and Leader (CNML) Practice Test

Which healthcare payment model typically involves payment per service rendered?

1. Capitation

2. Fee-for-Service

3. PPO

4. HMO

The correct answer is: Fee-for-Service

The fee-for-service model is characterized by payment for each individual service provided to a patient. Under this model, healthcare providers are reimbursed for every test, consultation, procedure, and other services performed. This approach incentivizes providers to offer more services since they receive payment for each one. It can lead to a higher volume of services being provided, regardless of the necessity or overall patient outcomes. In contrast, capitation entails a fixed payment per patient for a defined period, regardless of how many services the patient utilizes. Managed care organizations like PPOs (Preferred Provider Organizations) and HMOs (Health Maintenance Organizations) also operate on different structures, emphasizing cost control and often employing capitation or bundled payments rather than fee-for-service. Thus, fee-for-service remains distinct in its direct link between individual services rendered and payment, making it the correct answer in this context.