GH 301: Provider reimbursement changes the incentives you must evaluate
A payment method affects which risks are retained by a provider and which behaviours are rewarded. Evaluate cost, access and quality together, rather than interpreting lower expenditure as an automatic success.
Original practice scenario
For an original comparison, fee-for-service rewards activity while a defined prospective payment shifts some utilisation risk to the provider. Identify possible under-service, coding or selection concerns and specify a quality or access measure. Contract scope and risk adjustment determine the detailed incentives.
Study check
Write the assumptions, the decision being supported and one limitation. Use the current course syllabus for the required terminology and scope; this introductory guide is not a complete course summary.
Reading sources
ActNet editorial guide · October 1, 2026 · Original illustrative examples.