Who is the individual typically compensated on a fee-for-service basis in the health insurance context?

In the health insurance context, the individual typically compensated on a fee-for-service basis is the provider. This compensation model means that providers, such as physicians, hospitals, and specialists, receive payment for each specific service they deliver to patients. This model incentivizes providers to offer a higher volume of services, as their income is directly linked to the number of procedures, consultations, or treatments performed.

Fee-for-service arrangements are common in various health insurance plans and encourage a straightforward transaction: providers get paid according to the services provided, rather than receiving a flat rate or salary. This contrasts with other compensation structures, such as capitation, where providers receive a prepaid amount for a set number of patients regardless of the services rendered.

While brokers facilitate health insurance transactions, they typically earn commissions rather than a fee-for-service. The insured is the individual covered by the insurance policy and pays premiums for coverage, while adjusters work for insurance companies to evaluate claims but do not provide health services directly. Thus, the focus on the fee-for-service model appropriately highlights the role of providers in the healthcare ecosystem.