A primary care physician has been asked to speak to a local company. He works for a huge multi-specialty medical firm that he joined less than a year ago after finishing residency. The physician highlights the many medical specializations offered within the group, as well as the breadth of ancillary services accessible at the group's facilities, throughout the presentation. During the subsequent conversation, the physician discovers that the employer has been experiencing financial troubles. The firm desires to continue providing health care coverage to its employees but must cut costs. As a result, the employer wishes to arrange a contract in which the medical group provides treatment to all of the company's employees in exchange for a fixed monthly cost per employee. What payment method best reflects this sort of health care financing arrangement?

Question

Quizplus · Accepted Answer

Eductional Objective: Capitation is an arrangement in which a payor pays a fixed, predefined amount to supply all of a patient's services. Payors may enter into a capitated contract with an insurance company, which then pays the providers, or a big medical group may enter into a direct contract with the payor.

A Primary Care Physician Has Been Asked to Speak to a Local