What does capitation funding provide?
1. Admission criteria
2. Prospective payment
3. Retrospective payment
4. Personal payment
Correct Answer: 2
Under capitation, healthcare providers are paid a fixed dollar amount per person for providing an agreed-upon set of health services to a defined population for a specific period of time. If the costs of providing service are lower than the fixed amount, the provider organization makes a profit. Prospective payment is a payment mechanism for reimbursing hospitals for inpatient health care services in which a predetermined rate is set for treatment of specific illnesses. Admission criteria are used to verify the medical necessity of an inpatient stay. Personal payment is money for services not covered by insurance paid by the recipient of care; it may also include complete payment for healthcare services when the patient does not have any insurance coverage.
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