A huge chunk of the health care spending in the U.S today ends up unused or in the hands of insurers. As a result, providers are not left with any savings that are supposed to be theirs. As opposed to the volume-of-services type of payment model, the capitation payment arrangement addresses the problem with expenditure waste in the healthcare industry. The article published by the Harvard Business Review suggested that capitation is the only payment system that fully aligns providers’ financial incentives to eliminate all major categories of waste and shifts the role of managing the amount, form, and cost of care from insurers to medical practitioners.
It goes without saying that reviewing monthly capitation reports is a good practice to maintain. Capitation is a complicated process that must be consistently monitored. It helps providers track how much they’re getting paid according to the agreed terms between them and the health insurance. In order to conveniently assess capitation reports, a reliable capitation management software must be utilized in the process.
Capitation payments are used by managed care organizations (MCO) to control health care costs and resources by putting the physician at financial risk for services provided to patients. However, that doesn’t directly mean physicians are prohibited from using medical resources. It is the duty of the MCOs to see to it that patients still get optimal care by implementing health care services used to measure rates in physician practices.
Ultimately, capitation payment is a form of value-based payment arrangement that offers physicians the source of monthly income for their practice. It is in their own prerogative that physicians monitor their monthly capitation reports to ensure they are getting what they are promised based on the terms of their contracts.
Typically, in any capitation arrangements, providers receive a fixed payment from an assigned member every month whether or not the patient requires care during the month. The public can have access to these reports and the provider’s linked financial rewards can be referred to as the measure of health care quality. The capitation agreement that the physician signs usually contains a list of specific services that must be provided to patients and the amount of the capitation will be determined in part by the number of services provided. It differs depending on the health plan, but most capitation payment plans for primary care services include the following:
It is a big help for providers who need to access each enrollee’s agreed payment to have an accessible capitation payment management system. The problems that you used to encounter with capitation payments are resolved by integrating an advanced web application like QuickCap.
Review Accessible Capitation Report. Simply pull up capitation reports in just a few clicks. For every enrollee, records are made available for an easy viewing experience.
Calculate Capitation Payments. QuickCap is a centralized payment software that you can utilize to help you with capitation payment calculations for primary care providers (PCP). The calculations that you made can be sent for payment in one system.
Process PCP Capitation Checks. Generate PCP capitation checks seamlessly. Print the checks right from the system and log them in the check register to get back to them whenever you need to in the future.
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