title: Consumer turnover in service utilization patterns: implications for capitated payment.
abstract: Risk-adjusted capitation rates based on a group's expected cost to a provider have been proposed to create incentives for including people with severe mental disabilities in managed healthcare systems. The most appropriate methods for classifying people according to levels of risk, however, have yet to be determined. This research employed cluster analysis statistical techniques to identify patterns of services delivered to a sample of 4,346 consumers in Ohio. Findings about the extent of client movement in and out of service clusters over time suggest caution in the implementation of risk-adjusted capitation plans, particularly those based primarily on past service utilization.
authors.affiliation: Office of Program Evaluation and Research, Ohio Department of Mental Health, Columbus 43266-0414, USA.
authors.forename: D
authors.initials: D
authors.lastname: Roth
authors.forename: M B
authors.initials: MB
authors.lastname: Snapp
authors.forename: B G
authors.initials: BG
authors.lastname: Lauber
authors.forename: J A
authors.initials: JA
authors.lastname: Clark
mesh_terms: D002204:Capitation Fee; D016000:Cluster Analysis; D003156:Community Mental Health Services / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D006302:Health Services Research; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D009820:Ohio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011157:Population Dynamics; D012051:Reimbursement Mechanisms / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D013221:State Health Plans / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D013997:Time Factors; D014481:United States