What are payment capitalization?
Chapter payments are preliminary payments provided to healthcare providers from the health insurance company. This approach usually requires a fixed amount provided to the provider every month, and this amount is focused on annual or other regular inspection. Organization for health or HMO maintenance is one of the most common types of health insurance group plans that use this approach to pay doctors for services provided.
The idea of payments with capitalization is to ensure that members of the health care plan should prepare access to doctors, when and how it will be needed. At the same time, doctors participating in the arrangement have the advantage of knowing that they will have at least a minimum amount of income for each calendar month. The third advantage of this approach is the ability to reduce medical expenses, which theoretically helps to prevent these costs from increasing at the rate of economy.
Providers use various criteria to determine the amount of paymentsCapitalization to each physician associated with a plan. One of the factors in all situations is a number of services offered by every doctor. The number of members of the plan assigned as patients to this physician often also affects the amount of monthly payments. It is not uncommon for HMO to consider standard and usual health care costs in the area where the doctor is located.
While many doctors find that working with health maintenance and receiving chapter payments works very well, others are concluded with the program and then decide not to renew as soon as the initial contract is met. This is especially true when only a few local doctors participate in the plan and each of these doctors is assigned a large volume of patients. As a result, Physician may not be able to provide proper care to other more lucrative patients and the practice begins to lose money.
In addition to payments with capitalizationParticipants can receive a bonus annually. Many HMO follows what is called the risk fund. This is simply an account that is financed by the insertion of an amount equal to the specified percentage of payments offered by participating doctors. If the HMO has a good year and turns profit, these doctors receive part of this fund as a bonus. If the medical organization did not achieve profitability in a given calendar year, the funds in the risk fund are used to compensate for losses and not for any type of bonus involved doctors.