capitation


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Related to capitation: Capitation tax

capitation

 [kap″ĭ-ta´shun]
the annual fee paid to a health care practice by each participant in a health plan.

cap·i·ta·tion

(kap'i-tā'shun),
A system of medical reimbursement wherein the provider is paid an annual fee per covered patient by an insurer or other financial source, which aggregate fees are intended to reimburse all provided services.
[L.L. capitatio, fr. caput, head]]

capitation

(kăp′ĭ-tā′shən)
n.
1. A poll tax.
2. A payment or fee of a fixed amount per person, such as one remitted at regular intervals to a medical provider by a managed care organization for an enrolled patient.

cap′i·tate′ v.
cap′i·ta′tive adj.

capitation

Capitated payment Managed care
1. A method of payment for health services in which a physician or hospital are paid a fixed amount is paid per enrollee to cover a defined scope of services for a defined population set–aka covered lives for a defined period of time, regardless of actual number or nature services provided; capitation may be used by purchasers to pay health plans or by plans to pay providers;.
2. capitation payment is made on the basis of the number of members each month. See Bundling, Fee for service, HMO, Medicare risk contract, Per diem, PMPM, PPO, Rate setting. Cf Fee-for-service.

cap·i·ta·tion

(kap'i-tā'shŭn)
A system of medical reimbursement wherein the provider is paid an annual fee per covered patient by an insurer or other financial source; the aggregate fees are intended to reimburse all provided services.
See also: managed care
[L.L. capitatio, fr. caput, head]

cap·i·ta·tion

(kap'i-tā'shŭn)
A system of dental reimbursement wherein the health care provider is paid an annual fee per covered patient by an insurer or other financial source, which aggregate fees are intended to reimburse all provided services.
[L.L. capitatio, fr. caput, head]
References in periodicals archive ?
A review article reported the findings of a survey and medical records analysis focused on care provided to diabetic patients in capitated systems: "The authors reported that, under capitation incentives, there existed a smaller chance of the physician ordering a proteinuria assessment [a relatively inexpensive lab test which checks for kidney dysfunction]." (2)
"We received this capitation grant in October last year, the first one was on October 2014, we invested the money we received from capital grants for buying text books for students, we bought over 150 books also bought 13 tables and part of it went for student feedings", he added.
Capitation payments only should be adjusted by the age of patients being served; this cannot be falsified--older patients tend to use more health care services.
This can be a problem if the provider has a manually intensive procedure for generating claim reports from all of the HMOs for which they have capitation arrangements.
Behrman said some rough arithmetic showed that under a capitation model, well-organised GPs stood to turn over R1.5 million per annum versus the R750 000 some well-positioned GPs currently turned over (gross).
One of the problems with a capitation scheme is that the agreement is between you and a named dentist, so it is non-transferable.
From the inception of these programs and until January 1, 2000, capitation payment rates have been based on combinations of the demographic characteristics, age, sex, prepaid program, region, institutional status, Medicare coverage status, pregnancy status, parental status, and family income.
Capitation is a statistical and, more specifically, actuarial tool.
* General assumptions include critical assumptions, such as net monthly enrollment growth, average daily attendance at the PACE center, capitation rates and inflation factors, and capital requirements for building the PACE center.
The networks are compensated on a capitation basis.
The false promise of capitation is revealed when populations move, change plans annually or demand new technology not offered by last year's actuaries.
Some 78 percent of respondents to the 2000 Capitation Survey report that they are either seeking more capitation or are maintaining their current level of risk agreements.