A monthly fee paid for each member assigned or each event (for example, maternity delivery) regardless of the number or actual cost of services provided under a system of reimbursement for MCOs. Capitation rates can vary by member based on demographics, location, covered services, or other items. Capitation rates can be structured so that an MCO is fully at risk, or so that an MCO shares the risk with the state or with other MCOs. (Medicaid Managed-Care Capitation – Rate Development and Certification)
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