Straight Talk For Providers Adopting Capitation: Don’t Fly Blind Without The Right Data

August 26, 2020Garrett SchmittNo CommentsCapitated Payments, Captitation, Full Capitation

Value-Based Reimbursement—once focused on incentives and shared savings—now more often means capitation. Whether adopting Medicare Alternative Payment Models (APMs) or contracting with health plans, physician groups and health systems have signaled greater willingness to adopt these new Risk payment models with their guaranteed payments for attributed patients. But here’s the problem: If you don’t have good data…

Value-Based Care Defined: Know the Vocabulary of Health Care Reform

March 12, 2020Garrett SchmittNo CommentsAPM, Captitation, Corona, Coronavirus, Primary Care First

Today, as we confront a viral threat that is challenging our health system, its capacity, and how care is financed, it seems appropriate to review some fundamentals. Health care reform has been speeding down a particular track, changing how health care is covered, paid, delivered, and organized. These reforms may seem to be about health…

How Capitated Payments Prompt Payer, Provider Innovation

August 29, 2018Garrett SchmittNo CommentsCapitated Payments, Captitation, Full Capitation

The challenges of lowering care costs and improving healthcare quality may lead payers to consider the use of capitated payments as part of their value-based payment model strategies. Capitated payments are pre-arranged payments for healthcare providers to deliver services on a per member per month (PMPM) basis.  Providers are paid a set amount for each…

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