Withhold

1. Portion of the monthly capitation payment to physicians retained by the health maintenance organization (HMO) until the end of the year to create an incentive for efficient care. If the physician exceeds utilization norms, he or she will not receive it. Also called withhold incentive . 2. Percentage of payment or set dollar amounts that are deducted from the payment to the physician group/physician that may or may not be returned depending on specific predetermined factors.

Withhold fund

Account established to cover use of medical services that exceed the managed care plan budget. The funds are given to participating providers when medical services do not exceed the budget.

Withhold pool

Total amount that a health maintenance organization (HMO) retains from the providers’ payments until the end of the year. Cost of referrals and medical services that are considered excessive are held back by the HMO.