Which reimbursement model is associated with POS plans?

• A. Discounted fee-for-service
• B. Capitation
• C. Salary
• D. Global budget

Answer: (B)

Capitation is the reimbursement approach most closely tied to POS plans. Point-of-service plans blend HMO-style gatekeeping with some flexibility to go outside the network. To control costs and encourage coordinated care, POS arrangements often pay primary care physicians a fixed amount per enrolled member per period, regardless of how many services the patient uses. This per-member-per-month payment shifts some financial risk to the provider and motivates efficient care, preventive services, and appropriate referrals within the network. Patients can still see out-of-network providers, but often with higher cost sharing, while the in-network capitation underpins the core funding for primary care. Other models don’t align as naturally with POS structures: discounted fee-for-service would incentivize more services, salary removes activity-based incentives tied to enrollment, and a global budget is typically used for hospitals or large groups rather than individual PCPs in a POS network.