How Capitation Affects The Value Of An HMO Health Insurance Policy
Thursday, August 11th, 2011 by adminIn just the last few years, health care costs have gotten to the point where many people are turning away from obtaining a health insurance policy. Simply put, the health insurance rates now available are just too much for the average American to be able to afford. On top of that, much of the coverage is the same or even reduced while the costs have sky rocketed. Many employers no longer offer health insurance and if they do, they don't contribute as much which puts the financial burden back on the employee. But there are still some affordable options to be had for everyone - it's just a matter of searching for the right one. HMO health insurance policies are probably the most affordable for the average person because they limit you to a specific network. Combine that low cost with capitation, and you have an affordable plan that still provides adequate coverage.
For those who want a policy but can't afford the high costs of PPO plans, HMO health insurance policies are perfect. Additionally, if you are able to add capitation to your policy, you can save even more. Essentially, the way capitation works is that health care service providers are paid a certain fee per person on an HMO policy assigned to a particular physician or group of doctors. The amount that is paid to the doctor or group of doctors is based on the expected usage and care needed by the patient, which weighs past medical history, and a number of factors that can include race, sex, weight, type of employment, etc.
But unlike the way most physicians get paid from HMO or even PPO plans, they are not paid by the type of care given. In fact, the purpose of capitation is to keep the individual patient as healthy as possible and prevent them from contracting an illness or disease. Doctors are paid a set fee per person and there are no additional financial incentives for giving extra care. This means that the doctor will provide the exact treatment needed by considering the cost of treatment. This way, patients aren't made to take treatment or get procedures that are unnecessary. They instead receive the exact care they need to keep them healthy.
All of this makes an HMO policy with capitation very valuable for any individual holding the policy. They will end up paying an affordable rate for their policy while receiving the right kind of care. Individuals don't have to worry about having to go through unnecessary treatment or procedures that could be time consuming. No extra money is paid for additional services, which means you pay for what you need.

