Capitation

A risk arrangement in a managed care environment in which a health care provider is paid a fixed amount per month for each enrolled member in a health plan regardless of the actual number or nature of services provided to each person. The capitation contract may include a risk sharing arrangement, in which there is an allocation of financial results, both favorable and unfavorable, among the participants to the agreement.
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A method of payment for health services in which a physician or hospital is paid a fixed per capita amount for each person served regardless of the actual number of services provided to each person.

capitation (cap or CAP)

System of payment used by managed care plans in which physicians and hospitals are paid a fixed, per capita amount for each patient enrolled over a stated period of time (month or year), regardless of the type and number of services provided; reimbursement to the hospital on a per member per month (PMPM) basis to cover costs for the members of the plan.