Risk Management Expert Witness On Capitation

Risk management expert witness Stephen C. George, MBA-HA, President of Provider Risk, explains “capitation”:

A capitation is a fixed dollar amount per plan member per month paid to providers regardless of medical utilization. The payment structure shifts the financial risk from the insurance company to the physician or hospital accepting payment. Physicians and hospitals buy stop loss to limit any potential catastrophic medical financial loss on any one member per year.