capitated

A doctor receives a capitated payment for each patient in her care.

Definition

Adjective (Medicine / Healthcare Economics) - Relating to a system of payment for healthcare services in which a provider receives a fixed, prearranged amount of money per patient (or "per capita") for a specified period, regardless of the actual number or cost of services provided. - In a capitated payment model, the doctor is paid a set fee each month for each enrolled patient, covering all necessary care.

Usage Examples

• (The provider receives a fixed payment per patient, not per visit.)
• (The clinic is responsible for all care within the fixed budget.)
• (The fixed payment encourages keeping patients healthy.)

Advanced Usage

• "Capitated payment": a specific financial arrangement in healthcare.
  • Capitated payments shift financial risk from insurers to providers. (Providers must cover all costs within the fixed per-patient fee.)
• "Capitated rate": the fixed amount paid per patient per time unit (e.g., per month).
  • The capitated rate was negotiated at $85 per member per month. (The agreed fixed fee for each patient.)

Variants and Related Words

• Capitated (adj) — as defined above; also derived from "capitation" (noun).
• Capitation (noun): the system or practice of making capitated payments; a tax or payment levied on each person.
  • Capitation is a common funding method for community health centers. (Payment per person.)
• Capitatively (adverb): in a capitated manner.
  • The clinic is reimbursed capitatively for its enrolled population. (Via fixed per-person payments.)

Synonyms

• Per-capita-based: calculated or paid per person.
• Fixed-fee-per-patient: a set fee for each individual covered.
• Prepaid: paid in advance for a defined set of services.

Related Idioms / Phrases (Healthcare Context)

• "Per member per month (PMPM)": the specific unit used in capitated contracts.
  • The capitated contract pays $50 PMPM for primary care. ($50 per patient each month.)
• "Risk-adjusted capitation": a capitated payment adjusted for patient health status.
  • Risk-adjusted capitation ensures fairer payment for sicker populations.

Notes on Usage

• This term is almost exclusively used in healthcare policy, insurance, and managed care contexts. It is rarely encountered in general conversation.
• The adjective "capitated" is often paired with nouns like "model," "system," "payment," "plan," or "contract."
• Do not confuse with "capitalized" (related to capital assets) or "capitate" (having a head-like structure, in botany/biology).