Results for tag: "Capitation"

Capitation is a type of health insurance payment model in which a fixed amount is paid to a healthcare provider for each enrolled patient, regardless of the services provided. This payment model is often used in managed care plans, such as HMOs and PPOs, and is designed to incentivize providers to deliver cost-effective care. The provider is responsible for all costs associated with the patient's care, including preventive care, hospitalizations, and specialist visits. Capitation is a risk-sharing arrangement between the insurer and the provider, as the provider is responsible for any costs that exceed the fixed payment amount. This model is beneficial for insurers, as it helps to control costs and manage utilization. It is also beneficial for providers, as it provides a steady stream of income and allows them to focus on preventive care. Some companies in the capitation market include UnitedHealth Group, Anthem, Cigna, Humana, and Aetna. Show Less Read more