Question

Which of the following is a type of reimbursement by a health maintenance organization (HMO) to a group of physicians on a per-person-per-month contract?

a) Fee-for-service
b) Capitation
c) Medicare
d) Medicaid

Answer 1

In a capitation model, an HMO pays a group of physicians a fixed amount per patient per month, irrespective of the number of services each patient uses.

Step-by-step explanation:

The type of reimbursement by a health maintenance organization (HMO) to a group of physicians on a per-person-per-month contract is known as capitation. In contrast to a fee-for-service system, where providers are paid for each service rendered, capitation involves a fixed amount of money per patient regardless of how many services the patient receives. This system aims to provide incentives for healthcare providers to offer cost-effective care and to manage the overall use of healthcare services among their patients to prevent unnecessary procedures.