Capitation: prepare for the knock on the door.

R cforms in the nation's healthcare system are raising the pressure on managed care plans to capitate payments to physicians and hospitals, said David N . Schopp at the seminar " U n d e r s t a n d i n g Capitation and Risk Sharing," held following the Catholic Health Assembly (pp. 33-59). Insurance reforms, Schopp explained, will prevent a plan from using experience rating—that is, raising premiums when an employers' healthcare costs go up. Capitation shifts service and financial risks to the providers and aligns incentives of all parties in a health plan. Also, as health maintenance organizations (HMOs) get into Medicare risk contracting (and many are exploring this), they will often capitate the providers , said Schopp, who is the executive director of the Catholic Managed Care Consortium (CMCC), St. Louis, which cosponsored the seminar with the Catholic Health Association.