Recruiter's Glossary

Examples: Medical Coding • Fee-for-Service • Population Health

Capitation

Term from Medical Practice industry explained for recruiters

Capitation is a payment system in healthcare where medical providers receive a fixed amount of money per patient per month, regardless of how many services that patient uses. Think of it like a subscription model - instead of paying per visit, insurance companies pay doctors a set fee for each patient enrolled in their practice. This system is common in managed care organizations and medical practices. It's different from the traditional fee-for-service model where providers bill for each individual service. Understanding capitation is important because it affects how medical practices operate and manage their finances.

Examples in Resumes

Managed capitation contracts for a primary care practice serving 5,000 patients

Increased practice revenue by optimizing capitation payment arrangements with insurance providers

Developed tracking systems for capitation agreements covering 10,000+ patients

Typical job title: "Healthcare Practice Managers"

Also try searching for:

Medical Practice Manager Healthcare Administrator Medical Office Manager Practice Administrator Healthcare Finance Manager Managed Care Coordinator

Where to Find Healthcare Practice Managers

Professional Organizations

Job Boards

Professional Networks

Example Interview Questions

Senior Level Questions

Q: How would you evaluate whether a capitation contract is financially beneficial for a medical practice?

Expected Answer: A strong answer should include analyzing patient utilization rates, calculating costs per patient, comparing with fee-for-service revenue, and considering operational overhead. Should mention risk assessment and population health management strategies.

Q: What strategies would you implement to manage financial risk in a capitated payment system?

Expected Answer: Should discuss patient population analysis, preventive care programs, efficient resource allocation, proper staffing levels, and maintaining quality metrics while managing costs.

Mid Level Questions

Q: How do you track and monitor capitation payments to ensure accurate compensation?

Expected Answer: Should explain patient enrollment verification, monthly payment reconciliation, tracking of patient assignments, and working with insurance companies to resolve discrepancies.

Q: What are the key differences between capitation and fee-for-service payment models?

Expected Answer: Should explain how capitation provides predictable monthly income but requires careful patient management, while fee-for-service pays per service but can be less predictable.

Junior Level Questions

Q: What is a capitation payment and how is it calculated?

Expected Answer: Should explain that it's a fixed monthly payment per enrolled patient, typically calculated based on age, gender, and other demographic factors of the patient population.

Q: What basic reports would you prepare to monitor capitated contracts?

Expected Answer: Should mention patient enrollment lists, monthly payment reports, utilization tracking, and basic financial comparisons of expected versus received payments.