Thinking strategically about capitation.
All managed care stakeholders--health plan members, employers, providers, community organizations, and government entitites--share a common interest in reducing healthcare costs while improving the quality of care health plan members receive. Although capitation is a usually thought of primarily as a payment mechanism, it can be a powerful tool providers and health plans can use to accomplish these strategic objectives and others, such as restoring and maintaining the health of plan members or improving a community's health status. For capitation to work effectively as a strategic tool, its use must be tied to a corporate agenda of partnering with stakeholders to achieve broader strategic goals. Health plans and providers must develop a partnership strategy in which each stakeholder has well-defined roles and responsibilities. The capitation structure must reinforce interdependence, shift focus from meeting organizational needs to meeting customer needs, and develop risk-driven care strategies.
Boland
P
P
Boland Healthcare Inc., Berkeley, CA, USA.
D002204:Capitation Fee / Q000458:organization & administration*; D003363:Cost Control / Q000379:methods; D005376:Financial Management / Q000379:methods; D017048:Health Care Costs; D006305:Health Status Indicators; D008329:Managed Care Programs / Q000145:classification / Q000191:economics* / Q000592:standards; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms; D012308:Risk Management / Q000191:economics / Q000379:methods*; D014481:United States