Capitation fees paid by HMOs to hospitals, physicians, and other medical groups generally are based on the number of persons covered and expected costs to be incurred rather than on actual services provided.

Question

Quizplus · Accepted Answer

Capitation fees are pre-arranged payments made to healthcare providers by HMOs (Health Maintenance Organizations) based on the number of enrolled members, not on the actual services provided, aiming to cover expected healthcare costs for these members.

Capitation Fees Paid by HMOs to Hospitals, Physicians, and Other