Expect variation in utilization, revenue based on plan affiliation, warns Medicare risk provider.
Anatomy of a Medicare risk contract: A seasoned California Medicare provider shares the details on its risk contracts and warns other providers to expect wide variation in performance based on plan affiliation. Here's the "inside story" on how this provider has garnered 10% of the local market share, but it's sometimes been an uphill struggle.
D000368:Aged; D002140:California; D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D003284:Contract Services / Q000191:economics; D006279:Health Maintenance Organizations / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D006278:Medicare / Q000191:economics*; D018803:Models, Economic; D009935:Organizational Affiliation; D019982:Organizational Case Studies; D012308:Risk Management / Q000379:methods*; D014481:United States; D014600:Utilization Review