MANAGEMENT OF CAPITATION UNDER THE NATIONAL HEALTH INSURANCE SCHEME. BEING A PRESENTATION BY Dr HOPE UWEJA Gen. Manager ( Accr .& Insp ). MODE OF PAYMENTS UNDER MANAGED CARE. PER DIEM
BEING A PRESENTATION
Dr HOPE UWEJA
Gen. Manager (Accr.& Insp)
Capitation is a fixed amount of money
Per unit of time paid in advance to the Physician, Clinic or Hospital for the delivery of Healthcare Services
Actual amount of money paid is determined by
Range of Services provided
The number of Patients involved
Period of time during which the services
Note that Capitation rates are developed using local costs and average utilisation of services
Capitations are used to control use of Health resources by putting the Physician at Financial risk for Services provided to the patient
The possibility of Providers giving Suboptimal Care through under utilisation of Care Services
A function of the individual Primary Providers only.
The Providers are paid according to the number of enrolees attached to the facility
The Capitation is to be used for providing Primary healthcare services only.