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1 assess the financial risks they accept under capitation.
2 ntives to eliminate capacity and move toward capitation.
3 We begin by reviewing the basic concepts of capitation.
7 influence the behavior of physicians through capitation and utilization review, the major health plan
9 , varies by specialty, practice setting, and capitation, and therefore may increase with current tren
10 practices, those who received revenues from capitation, and those who served as gatekeepers for thei
12 based Payments for Primary Care (3PC), a new capitation-based primary care payment system, in 2016.
15 ertise in utilization management, and global capitation contracts with health insurance entities.
16 are more specific than common terms, such as capitation, fee for service, global payment, and cost re
17 rivate finance initiative; and the change to capitation funding streams, which allows the substitutio
19 that includes a discussion of the effects of capitation, how preventive care can be cost effective, a
20 s that blend elements of fee-for-service and capitation in innovative ways for primary care and speci
21 models of remuneration (fee for service and capitation), less is known about pay for performance and
24 rotect vulnerable patients by risk-adjusting capitation payments and by focusing resources on care fo
25 managed care has had little experience with capitation payments for chronically ill patients, who co
26 be meeting its intended goal by aligning the capitation payments to the health care burden of the ind
28 ity imaging services were provided under the capitation plan with financial savings by the employer.
31 Medicare diagnosis-related-group payment and capitation reimbursement, can also be effective in conta
32 cians with at least 30% of their income from capitation requested 38% more and were asked to provide
35 Under certain conditions, conversion to a capitation system for imaging can lead to improved quali
36 yment based in large part on empanelment and capitation to improve outcomes and accountability, suppl
37 care providers (PCPs) as gatekeepers, use of capitation to pay PCPs, and whether the plans themselves
38 ntly about caring for patients covered under capitation vs those covered through more traditional for
39 result from financial incentives inherent in capitation, while the focus on preventive services may s
41 ods blending elements of fee-for-service and capitation will outperform exclusive reliance on either