What Is a Capitated Payment Model?
A capitated payment model is a system where healthcare providers are paid a set, prepaid amount for each patient over a specific period, regardless of how much care that patient needs. This payment arrangement is known as capitation.
Why It Matters
This model shifts the financial risk to providers, incentivizing them to focus on preventive care and efficiency to keep patients healthy and costs down. It moves the focus from the quantity of services to the quality of patient health outcomes.
How Mira Mace Can Help
In a capitated system, there can be a risk of under-treatment. Your advocate ensures you receive all necessary care, helps you navigate any restrictions on specialists or treatments, and appeals on your behalf if you feel your access to care is being unfairly limited.