Capitated Financial Alignment Model ( Clause Samples
The Capitated Financial Alignment Model is a contractual arrangement in which a single payment is made to a healthcare provider or organization to cover the comprehensive care needs of a defined patient population over a set period. Under this model, the provider assumes responsibility for managing all covered services within the fixed payment, incentivizing efficient care coordination and cost control. This approach is commonly used in managed care settings to align financial incentives with quality outcomes, ultimately aiming to reduce unnecessary spending and improve patient care by shifting financial risk from payers to providers.
Capitated Financial Alignment Model (. (“the Demonstration”) – A model where a State, CMS, and a health plan enter into a three-way Contract, and the plan receives a prospective blended Capitation Payment to provide comprehensive, coordinated care.
Capitated Financial Alignment Model (. A model under the Medicare-Medicaid Financial Alignment Initiative where a State, CMS, and a health plan enter into a three-way Contract, and the health plan receives a prospective blended payment to provide comprehensive, coordinated care. Phase II of the ICI uses the Capitated Financial Alignment Model.