New capitation scenarios for HMO Medicare risk contracting.
Medicare's current method for setting capitation rates does not provide adequate financial incentives for HMOs to offer managed care products; more than 60 percent of the nation's HMOs still do not participate in Medicare risk contracts. Possible changes to the capitation calculation method could provide the necessary financial incentives for Medicare HMOs to proliferate and ease the strain on the Medicare trust fund. Managed care organizations need to prepare to enter the Medicare risk-contracting arena.
Grimaldi
P L
PL
Birch & Davis Health Management Corp., Silver Spring, MD, USA.
D002204:Capitation Fee / Q000145:classification / Q000592:standards*; D003284:Contract Services; D005249:Fees and Charges / Q000639:trends; D005376:Financial Management; D006279:Health Maintenance Organizations / Q000191:economics*; D006278:Medicare / Q000191:economics* / Q000458:organization & administration; D011907:Rate Setting and Review; D012052:Reimbursement, Incentive / Q000191:economics / Q000639:trends*; D012308:Risk Management / Q000191:economics; D014481:United States