The need for integrated risk management in capitated provider groups.
Financial risk is not just ensuring that there is enough capitation revenue to cover claims for services. The changing world of health care is devolving risk and exposures to provider groups that were previously covered by insurance companies, HMOs, and other payers. Capitated providers must first understand the risk they face and then manage it. There is more to be gained in terms of independence than to be feared in additional administrative work.
Van Loon
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PA
ConnectiCare, Inc., Farmington, CT, USA.
D000206:Actuarial Analysis; D002204:Capitation Fee; D006125:Group Practice, Prepaid / Q000191:economics; D016365:Liability, Legal; D008329:Managed Care Programs / Q000191:economics*; D010934:Planning Techniques; D011216:Practice Management, Medical / Q000191:economics*; D012308:Risk Management / Q000191:economics*; D014481:United States