Network capitation plans: an operational perspective.
Dentistry's mission has been defined as improving the oral health of the public. In the ADA's report on the strategic plan for dentistry, the first priority addressed is to convert public unmet needs into a demand for dental services. One of the methods which the plan has outlined for action is to "expand dental prepayment and promote growth of innovative payment mechanisms." The prepaid capitation method of payment can and will provide a vehicle to service those unmet needs. Healthcare insurance companies are organizing regional and national networks of individual practices who will accept this method of prepayment. As in all systems of delivery, there are possibilities for abuse. This article addresses a prepaid capitation delivery system from an operational perspective, in order to identify the elements that should safeguard the patient, dentist, employer group, and carrier.
Calkins
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Turner
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Brady
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D002204:Capitation Fee; D003258:Consumer Behavior; D003695:Delivery of Health Care / Q000191:economics; D005249:Fees and Charges; D005250:Fees, Dental; D006801:Humans; D007347:Insurance, Dental / Q000191:economics*; D010342:Patient Acceptance of Health Care; D011785:Quality Assurance, Health Care / Q000191:economics; D012052:Reimbursement, Incentive