US Medical Term · insurance
Capitation
Capitación
In 9 languages
| Language | Term |
|---|---|
| English | Capitation |
| Spanish (Español) | Capitación |
| Chinese (中文) | 人頭費 |
| Korean (한국어) | 인두세 지불 |
| Vietnamese (Tiếng Việt) | Chi phí bình quân đầu người |
| Filipino (Tagalog) | Capitation |
| Portuguese (Português) | Capitação |
| Thai (ภาษาไทย) | การจ่ายแบบรายหัว |
| Japanese (日本語) | 人頭払い |
What it means
Capitation is a payment model in which a health plan pays a fixed monthly amount per enrolled patient to a provider or medical group — regardless of how many services that patient actually uses. Instead of billing per visit, the provider receives a set per-member, per-month (PMPM) fee to cover all contracted services. This model is common in HMO plans. For patients, capitation means your PCP is paid the same whether you visit once or ten times in a month. Providers have a financial incentive to focus on preventive care to keep patients healthy rather than ordering unnecessary tests.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
Is my primary care doctor paid through capitation by my HMO?
¿Mi médico de atención primaria recibe pago por capitación a través de mi HMO?
Will capitation affect what services my doctor is willing to provide?
¿La capitación afectará los servicios que mi médico está dispuesto a brindar?
Does my plan use capitation or fee-for-service payments to providers?
¿Mi plan usa capitación o pagos por servicio para los proveedores?
Where you'll see it
Related terms
Sources
Last reviewed: September 2026