Certified Materials and Resource Professional Practice 2026 – All-in-One Guide to Exam Excellence!

A Capitated Agreement refers to a healthcare payment model where a healthcare provider is paid a set amount for each enrolled person assigned to them, typically per month, regardless of whether that person seeks care or how many services they utilize. This makes the option referring to fixed payments regardless of the number of services provided the correct answer.

In this arrangement, the provider assumes the financial risk associated with offering care because they receive the same amount regardless of patient volume or service intensity. This structure incentivizes providers to focus on preventive care and efficient service delivery, as they maximize their profit by managing the care needs of their patients effectively.

The other choices reflect different payment models or arrangements that don't align with the principles of capitated agreements. For example, payments based solely on hospital performance metrics focus on outcomes and can fluctuate based on certain quality metrics. The option relating to costs based on the number of procedures emphasizes a fee-for-service model, which contrasts with the fixed nature of capitation. Lastly, payments that increase with patient volume correspond to a variable payment model rather than the fixed payment structure inherent in capitated agreements.