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Capitation

A payment based on the individual (for a set period of time) rather than a per-service payment. Insurance plans tend to pay a physician network a certain per member per month payment to cover all of the services needed by that individual.

Cost-Sharing Reduction (CSR)

A provision in the Affordable Care Act that lowers the amount an individual pays out-of-pocket for deductibles, coinsurance, and copayments. Individuals can qualify if they…