With full capitation, a healthcare provider receives a fixed payment (capitated) per year per member and agrees to meet all the care needs of a broad patient population. Providers are not reimbursed for services that exceed the capitated amount, so while full capitation creates a steady revenue stream, it also comes with risk. It helps payers control their costs because they know in advance what they will spend on healthcare for their entire group of members.
Full capitation is the end goal of a value-based care system. The model incentivizes providers to provide more efficient care, and shared savings in some models can further incentivize providers.
Full Capitation was a healthcare industry trend in our 2022 March Healthcare Classic. Explore this year’s interactive bracket to see the most impactful healthcare trends face off.