What does capitation often unintentionally limit in healthcare delivery?

Capitation is a payment model in which a healthcare provider is paid a set amount for each enrolled patient, regardless of the quantity or type of services provided. This financial structure can unintentionally limit preventive care services because providers may prioritize direct or urgent treatments over preventive measures, which may not be as immediately profitable.

Under a capitation model, providers receive the same payment whether they conduct a preventive exam or not. This can create a disincentive for them to invest time and resources in preventive care, which is often essential for catching health issues before they escalate into more serious and costly conditions. As a result, patients may receive fewer preventive screenings and interventions, ultimately impacting overall health outcomes.

While the other options—specialty physician services, emergency medical services, and diagnostic testing—may also be affected to some extent by the financial dynamics of capitation, the most significant and direct limitation is typically seen in the realm of preventive care. This is primarily because the immediate financial incentives in capitation may favor treatments that generate more revenue rather than ones that focus on prevention, which pay off in the long term.