Module 2
Payment Models
The spectrum of value-based arrangements, from pay-for-performance through shared savings, bundles, and full capitation, and how each changes incentives.
By the end of this module, you will be able to:
- Place any payment arrangement on the risk spectrum from bonuses to full capitation
- Explain how an ACO benchmark and quality gate together determine whether savings are earned
- Compare bundled payment and capitation by what each can and cannot accomplish
- The Risk Spectrum One question organizes every payment model: how much financial risk does the provider hold? About 4 min
- Shared Savings and ACOs How accountable care organizations earn, and lose, against spending benchmarks, and what the evidence shows. About 5 min
- Bundled Payments and Episodes of Care One price for the whole clinical journey: how episodes are defined, where bundles work well, and what they cannot do. About 4 min
- Capitation and Global Budgets At the deep end of the risk spectrum, providers live within a fixed budget. This lesson covers how capitation and global budgets work and the guardrails they require. About 5 min
Module quiz
Answer all questions to see your score.
1. What single question best organizes the landscape of value-based payment models?
From pay-for-performance bonuses to full capitation, models are waypoints on a spectrum of provider risk.
2. An ACO's benchmark is built from its own historical spending. What structural problem does this create?
Historical benchmarking means this year's savings become next year's harder target, while historically wasteful organizations get easy wins.
3. Why are joint replacement episodes the strongest case for bundled payments?
Surgical episodes offer concrete levers (implant choice, post-acute pathways, complication prevention), which is where bundle evidence is strongest.