Paying for HMO Care: Issues and Options in Setting Capitation Rates

As the public and private sectors continue to promote use of capitated health care systems, the problem of how to establish payment rates for individuals becomes increasingly important. Inattention to pricing policies can lead to increased total costs, windfall profits for some providers, and the loss of comprehensive coverage for highrisk individuals. Capitation systems used by government and corporations are measured against social and economic ideals; the shortfall can be addressed by proposed new alternatives.

Author(s): Gerard F. Anderson; Earl P. Steinberg; James Holloway; Joel C. Cantor

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Volume 64, Issue 4 (pages 548–565)
Published in 1986