Kapitationsmodellen

The Kapitationsmodell, or capitation model, is a healthcare payment system where healthcare providers are paid a fixed amount per patient, per unit of time, regardless of how many services the patient receives. This payment is often referred to as a "capitation fee." The core principle is to pre-pay for healthcare services, shifting the financial risk from the payer (e.g., insurance company or government) to the provider.

Under this model, a provider, such as a doctor's office or a clinic, receives a set payment for each individual enrolled in their care for a defined period, such as a month or a year. If a patient requires minimal care during that period, the provider still receives the full capitation payment. Conversely, if a patient requires extensive or costly services, the provider bears the cost beyond the pre-determined fee.

The objective of the Kapitationsmodellen is often to incentivize providers to focus on preventative care and efficient resource utilization. By being responsible for the total cost of care for their enrolled population, providers are encouraged to keep patients healthy and avoid unnecessary procedures. This can potentially lead to cost savings for the healthcare system as a whole. However, critics sometimes express concerns that the model could lead to under-treatment if providers prioritize financial gain over patient needs, although contractual agreements and quality measures are typically in place to mitigate this risk.