capitated


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Related to capitated: capitated rate

capitated

(kăp′ĭ-tā′tĭd)
adj.
Characterized by or requiring capitation: a capitated HMO.
References in periodicals archive ?
As a consequence, results for access at the HMO level increasingly could become an average of the performance of many different capitated provider organizations.
Under the first variation, Medicaid contracts on a capitated basis with a single entity that is responsible for the provision of all mental health services to beneficiaries in the State.
Before I discuss the ways I see this change happening, however, I would like to address the model, namely that of a capitated, hospital-centered, vertically-Integrated system.
By challenging healthcare providers to assume some level of risk for patient outcomes, while offering incentives, it was reasoned that capitated payment arrangements might provide a solution by lessening the fiscal difficulties of state Medicaid programs and by addressing the access, quality, and coordination problems found in some Medicaid fee-for-service settings.
Finally, capitation provided all funds paid up front and all services delivered as costs against fixed revenue from the capitated compensation pool.
Over 30% of the populations of California and Massachusetts are currently enrolled in capitated plans.
Predictable in almost every metropolitan area, therefore, is a surplus of specialty physicians and a restricted number who are eligible (because of being excluded from specific panels) to receive payment from some capitated HMO plans.
Aiming to unify public funding streams into capitated rates paid to a continuum of providers, it has just begun operations and is not anticipating large growth, expecting to encompass only some 4,000 elderly over the next five years.
Systems must contract with individual primary care physicians (who are capitated for primary care only) to place their patients in the system's risk pool; the systems have minimal control over patient flow.
An example of this might be the patient who is referred to your facility by a case manager of a large medical group that is partially capitated by a health maintenance organization that offers a senior plan to its enrollees who assign their Medicare benefits - i.
BAD HOMBURG, Germany -- Fresenius Medical Care AG ("the Company") (Frankfurt Stock Exchange: FME, FME3) (NYSE: FMS, FMS-p), the world's largest provider of Dialysis Products and Services, today announced that the Centers for Medicare and Medicaid Services (CMS) has awarded Fresenius Medical Care North America (FMCNA) and its wholly owned subsidiary Fresenius Medical Care Health Plan (FMCHP) a four year capitated End Stage Renal Disease (ESRD) demonstration program.
During the first year there were many turning points that felt like a hairpin ride around Dead Man's Curve: Payers hesitated to negotiate capitated contracts; hospitals withdrew financial support once promised; and hospital employed physicians transitioned from the PO to a PHO.