title: An analysis of capitation rates for prescription medication benefits from an insurance perspective.
abstract: The use of capitation payment systems to control costs for prescription medication benefits appears to be increasing. In such a system, risk is transferred to a pharmacist or group of pharmacists. The author examines the nature of that risk, factors that must be considered in setting capitation rates and ways to control risk in a capitation system. An insurance pricing model is used to calculate risk-adjusted capitation rates using observed and hypothetical data, and implications for pharmacists and insurers are discussed.
authors: University of Texas at Austin.
authors: K A
authors: KA
authors: Lawson
mesh_terms: D002204:Capitation Fee / Q000458:organization & administration*; D003363:Cost Control / Q000379:methods*; D017049:Employer Health Costs; D005252:Fees, Pharmaceutical; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D015233:Models, Statistical; D011907:Rate Setting and Review / Q000379:methods; D012051:Reimbursement Mechanisms / Q000191:economics; D012308:Risk Management / Q000191:economics / Q000379:methods; D014481:United States