capitation

It is based on the ability of the state’s integrated medical groups to provide high-quality care at a lower cost by receiving monthly revenue per enrollee, a payment system known as capitation.

It’s called capitation, and the idea was to encourage medical providers to be more efficient.

If the doctors overprescribe, they could lose money on patient care; if they keep services under control, they pocket more of the capitation for themselves.

Iora, for example, operates through Medicare Advantage on what is known as a capitation system, getting a set amount for the care of each patient that includes health coaching.

The survey was the first independent study concerning the payment model known as capitation, or payment transformation.