Paying for HMO care: issues and options in setting capitation rates.
As the public and private sectors continue to promote use of capitated health care systems, the problem of how to establish payment rates for individuals becomes increasingly important. Inattention to pricing policies can lead to increased total costs, windfall profits for some providers, and the loss of comprehensive coverage for high-risk individuals. Capitation systems used by government and corporations are measured against social and economic ideals; the shortfall can be addressed by proposed new alternatives.
D002204:Capitation Fee; D003256:Community Participation / Q000191:economics; D004465:Economic Competition; D005249:Fees and Charges; D006279:Health Maintenance Organizations / Q000191:economics*; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D006278:Medicare; D011907:Rate Setting and Review / Q000379:methods*; D012306:Risk; D014481:United States