Since the mid 1990s, in some counties GPs receive an additional capitation fee for each patient, to increase their monthly income.
Advocacy at each of these levels to increase allocation of capitation grant funds to preprimary schools is needed.
After several years of operation, it was found that there was no need to increase the level of capitation payments, as the number of 'high-cost' inpatient cases remained low and medical expenditures remained below revenue generated from capitation payments (Ron 1999).
In addition, federal and state governments need to reinstitute a highly successful program, the capitation grant program, used in the early 1970's to increase the number of students admitted to schools of nursing.
Therefore, we assume that GPs who are paid a fee-for-service have more opportunities to increase their income and will thus have a higher income compared to their salaried and capitation fee paid colleagues.
Finally, by design, this analysis is limited to the first year of the expanded bundle implementation; future research should assess whether the differential effect diminishes over time by including subsequent years when phasing facilities are subject to increased capitation.
A further difference that should be highlighted is that English GPs are paid under a capitation scheme to provide incentives for promotion and prevention activities.
Under capitation, an organization — for example, a large, multispecialty medical group or a staff-model health maintenance organization such as Kaiser Permanente in California — willing to coordinate all care an individual may need during an entire year against a prepaid flat capitation receives a payment that is adjusted for the expected, actuarial risk of the patient.
Under capitation, physicians receive the same monthly capitation payment per patient regardless of the number of visits a patient makes.
Andoh-Adjei et al. [3] observed that health insurance subscribers in Ghana have high trust in their primary care provider for giving them quality care under capitation payment despite their negative attitude towards capitation payment.
