What Is A Medicare Capitation Agreement

When the primary care provider signs a top performance agreement, a list of specific services that must be made available to patients will be included in the contract. The level of the per capita plan is determined in part by the number of services provided and varies from one health plan to another, but most payments for primary care services are as follows: the level of the per capita plan is determined in part by the number of services provided and will vary from one health plan to another. Most kite payment plans for primary care services cover key areas of health care. The Office of Research and Demonstrations supports several studies of AAPCC`s methodology, including the feasibility of integrating health adjustments and the study of the five-year deferred method for the moving average for calculating adjustment factors in counties. Most of these research activities will be completed in 1986 and 1987 and will provide the HCFA with comprehensive information to refine the current Medicare HMO program and to develop new directions for head policy. As shown in Figures 1 and 2.2, the number of Medicare beneficiaries enrolled in prepaid organizations on at-risk contracts has increased. and the number of contracts at risk between 31 December 1979 (before HMO risk events) and 31 March 1986 (approximately 1 year after the introduction of TEFRA). , led to an increase of nearly 300. Percentage of beneficiaries enrolled in prepaid plans (527,521 registered as of December 31, 1979, compared to 1,428,309 at March 31, 1986). If wholesale health plans (which only cover Part B services) are not counted, this figure is even more dramatic – an increase of more than 3,000 per cent. Despite these increases, it is important to keep in mind that the free movement of beneficiaries in prepaid plans is still in its infancy.

As of March 31, 1986, Medicare`s total population, enshrined in some sort of prepaid plan, was 4.6 percent, with 2.2 percent enrolled in a prepaid plan with a risk contract.5 At the national level, Medicare recipients make about 7.6 percent of total HMO enrollment.