What does PMPM stand for in the context of risk adjustment payments?

What does PMPM stand for in the context of risk adjustment payments?

• A. Projected monthly payment.
• B. Per-member per-month actual cost.
• C. Per-visit per-month payment.
• D. Per-member per-month capitation payment.

Answer: (D)

PMPM stands for per-member per-month—the rate used to express payments on a monthly basis for each enrolled individual. In risk adjustment and capitation models, plans receive a fixed amount for every member each month to cover expected care costs. That monthly per-member payment is exactly a PMPM, making the capitation framing the most appropriate description. The other options describe different concepts (like a projected or actual monthly cost or a per-visit charge), which aren’t what PMPM denotes.

PMPM stands for per-member per-month—the rate used to express payments on a monthly basis for each enrolled individual. In risk adjustment and capitation models, plans receive a fixed amount for every member each month to cover expected care costs. That monthly per-member payment is exactly a PMPM, making the capitation framing the most appropriate description. The other options describe different concepts (like a projected or actual monthly cost or a per-visit charge), which aren’t what PMPM denotes.