HealthIT Answers May 22, 2024
Industry Expert

By David L. Morris, Executive Vice President & Chief Commercial Officer, Cedar Gate Technologies

The healthcare industry is witnessing a monumental shift toward alternative payment models. Among them, capitation is growing in popularity as one of the most durable ways to stabilize costs and focus on preventive and primary care. Much of the push toward partial or global capitation comes from the success of delegated risk and risk-based programs like the Centers for Medicare & Medicaid Services’ (CMS) ACO REACH (Realizing Equity, Access, and Community Health), and ACO Primary Care Flex, which incentivize preventive care and efficient use of resources.

Capitation, which provides a fixed per-member payment for a specified period, benefits patients, payers, and providers. Patients have expanded access...

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Topics: ACO (Accountable Care), Insurance, Payer, Payment Models, Provider, Value Based
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