CMAA Practice Exam 2025 – Complete Guide for Exam Prep

Capitation refers to a payment model in healthcare where a fixed fee is paid monthly for each enrolled patient, regardless of the number of services or the amount of care provided. This model is designed to encourage healthcare providers to focus on preventive care, as they receive the same amount regardless of how many times a patient may visit or what services they require. By paying a set fee per patient, the emphasis is on managing overall patient health efficiently, rather than incentivizing more frequent visits or services.

In contrast, payment per service rendered would mean providers are paid for each individual service, which can lead to an increase in the quantity of services rather than quality of care. A percentage of charges refers to a reimbursement model where providers receive a set percentage of the total charges for services rendered, which varies significantly based on the services provided. Salary-based compensation means providers are paid a salary irrespective of the number of patients treated or services provided, which does not reflect the unique structure of capitation payments. Thus, capitation is specifically designed to create a predictable revenue stream while encouraging proactive and preventative care management.