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Secondary capitation is a relationship arranged by a managed care organization between a physician and a secondary or specialist provider, such as an X-ray facility or ancillary facility such as a durable medical equipment supplier whose secondary provider is also paid capitation based on that PCP's enrolled membership.
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
How healthcare payment is managed is one of key policies that countries have to drive healthcare system. Payment for healthcare is managed in various ways. The main categories of payment systems are salary, capitation, bundled payment, global budget and fee-for-service. Most countries have mixed systems of physician payment. [1] [2]
Bundled payment is the reimbursement of health care providers (such as hospitals and physicians) "on the basis of expected costs for clinically-defined episodes of ...
[4] [5] The capitation fee has been considered to be one of the reason for the exorbitant hike in healthcare costs and deteriorating medical standards. [6] [7] The capitation fee comes as a surprise to the student when the student may have forsaken admission deadlines at other institutions.
Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care – mostly, traditional health maintenance organizations (HMO) and primary care case management (PCCM) arrangements.
The IPA assembles care providers in self-directed groups within a geographic region to invent and implement health improvement solutions, form collaborative efforts among care providers to implement these programs, and exert political influence upward within the community to effect positive change.
Capitation may refer to: Poll tax or head tax, a tax of a fixed amount per individual; Capitation (healthcare), a system of payment to medical service providers; Capitation fee, a fee or payment of a uniform amount charged per person