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. 2019 Oct 30;9:30. doi: 10.1186/s13561-019-0247-5

Table 1.

Framework for the characteristics of capitation payment mechanism

Attribute Definition Levels
1. Adequacy or sufficiency of the payment rate The extent to which the payment rate covers the costs of services purchased

Adequate

Inadequate

2. Predictability of payment amounts Whether providers know what amount to expect

Predictable

Unpredictable

3. Predictability of payment patterns Whether providers know when they will get paid

Predictable

Unpredictable

4. Complexity of the accountability mechanisms associated with the PPM The complexity of the accountability and reporting mechanisms associated with the PPM

Simple accountability requirements

Complex/burdensome accountability requirements

5. Service coverage of the PPM The range of services the PPM is paying for Outpatient services, inpatients services, dental, optical, surgical, nursing care
6. The performance requirements of the PPM Whether the PPM is tied to performance

Payments tied to performance

Payments not tied to performance

7. Flexibility or autonomy of the PPM Autonomy health care providers have to spend or use the PPM funds on anything

Autonomous (Flexible)

Restricted (Rigid)

Adapted from RESYST consortium’s framework on the characteristics of multiple funding flows [32]