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An HMO or other managed care plan can contract with an IPA, which in turn contracts with independent care providers or physicians to treat members at discounted fees or on a capitation basis. The typical IPA encompasses all specialties, but an IPA can be solely for primary care, could be single specialty, or could be a set of other care ...
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.
(The Center Square) – New laws go into effect in Illinois Jan. 1 that will put new restrictions on the state’s health insurance industry. Gov. J.B. Pritzker said the Healthcare Protection Act ...
Secondary capitation is a relation arranged by care organization between a physician and a secondary or specialist provider, i.e. or ancillary facility or an X-ray facility. Global capitation is a relationship based on a provider who provides services and is reimbursed per-member per-month for the entire network population.
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U.S. health insurers Cigna and Humana are in talks to merge, a potential deal likely to face aggressive scrutiny from the U.S. Justice Department (DOJ) if antitrust history with similarly sized ...
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