A method for capitation rate calculation using financial data readily available to the laboratory manager.
The advent of managed care has expanded the universe of information needed by laboratory administration to properly manage a clinical laboratory. This article presents a method for calculating proposed capitation rates for laboratory services using financial information that is readily available to the laboratory manager. Having this information is essential before entering into negotiations with a managed care organization and also gives the manager information regarding the laboratory's competitive position in relation to market capitation rates. Once a cost-based capitation rate is determined, laboratory administration must assess whether or not to pursue the contract and how it can be consummated. This article briefly outlines questions to consider in determining whether and how to proceed in contracting with a managed care organization and the ongoing analysis that is required after the contract is won.
Venner
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St. Joseph Mercy Hospital, Ann Arbor, MI, USA.
D002204:Capitation Fee; D003164:Competitive Bidding; D003363:Cost Control; D017598:Efficiency, Organizational; D006740:Hospital Administrators; D007755:Laboratories, Hospital / Q000191:economics* / Q000458:organization & administration; D008329:Managed Care Programs / Q000191:economics; D008824:Michigan; D011907:Rate Setting and Review / Q000379:methods*