In a 'capitated payment model', how are healthcare providers compensated?

Prepare for the Highmark Exam 1 with comprehensive study materials. Answer multiple choice questions, each with hints and explanations, to get ready for your examination!

In a capitated payment model, healthcare providers are compensated by receiving a fixed amount per patient for a defined period, regardless of the number of services provided or costs incurred during that time. This payment structure is designed to encourage preventive care and efficient management of healthcare resources since providers benefit financially by keeping patients healthy and potentially reducing the number of services needed.

In this model, the provider is incentivized to offer appropriate care because their revenue does not directly correlate with service volume. Instead, it is based on the patient population they serve, promoting a focus on managing health outcomes rather than on quantity of care. This approach contrasts with more traditional fee-for-service models, where payments are made for each individual service, regardless of the patient's overall health.

The other choices describe different payment models that do not align with the principles of capitation. For instance, compensation based on the number of services or a percentage of total costs involves a different financial incentive structure, which emphasizes the volume of care rather than patient management.

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