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fee-for-service equivalent

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fee-for-service equivalent,
(in U.S. managed care) a specialty capitation method in which a fee schedule is developed for service and providers are paid a percentage of the fee schedule. Periodically the overall value of services provided is compared with payments received and the balance is distributed proportionately to participating providers.


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The upside potential is actuarially determined and prefunded, in most cases by lowering physician payment through the use of capitation from the market-based fee-for-service equivalent.
 
 
 
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