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Health · Chapter 14 · Managed Care Networks

Capitation

Definition
Compensating providers per patient, not per service — the HMO pays a flat fee per subscriber. Unused? The HMO wasted the fee. Overused? The provider eats the loss. This shared 'utilization risk' is the opposite of fee-for-service.
In plain English
The doctor gets the same check whether you visit zero times or twenty.
Easy to confuse with

These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.

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Verified against primary sources · 2026-08-07