In Texas STAR+PLUS, the capitation
amount for Medicaid-only participants is based on FFS costs for both acute care and LTC services.
A variety of niche software applications have been developed for interfacing into existing core capitation
systems to enhance their use.
If a physician group's percentage of HMO capitation
is anticipated to grow, consideration should be given to changing to the accrual basis to avoid paying taxes on money reserved to pay outside providers.
The scandal of high capitation
fee and seat auctioning in medical colleges in Tamil Nadu and neighbouring Karnataka states continues to haunt many parents and students alike.
In the period immediately following capitation
, the first 3 months were viewed as an implementation period, and were excluded from the CEA as were the corresponding periods in the second period postcapitation and precapitation.
rates are set by each participating state and developed based upon the state's estimate of the costs for a comparable population.
The issue of whether capitation
and financial incentives are proper--or whether they create a conflict of interest for physicians--may be decided by the U.
What distinguishes a prospective risk-adjusted capitation
model is that the relative size of the advance payment levels is based on a measure of the prior risk of each enrollee, where the prior risk of each enrollee is captured by explicit measures of their health status from one point in time, to predict their utilization for a later payment period.
In regions where capitation
has not taken hold, hospitals are caught in an increasingly tight squeeze.
does have a future, but it will have to evolve as different markets continue to evolve.
10] The patient's attorney argued that such a referral would have cost the physicians more than $1,000 because the patient was insured under a capitation
A 1999 nationwide survey by the Healthcare Intelligence Network (Atlanta, GA) has shown that doctors are losing money on capitation
contracts; fewer than one-third of the surveyed medical practices reported making a profit on capitation
, down from 52% in 1997, reports American Medical News.