Managed care, capitation, and the future of nephrology.

The future role of managed care and capitation in worker's compensation.

Managed care fundamentals: implications for health care organizations and health care professionals.

Managed care is changing our health care delivery system as radically as the computer chip has changed telecommunications. Health care professionals and organizations that do not understand managed care's implications will not be prepared for the future. For example, one implication of managed care is payment capitation, which is the transfer of financial risk from the insurer to the provider. ...

Do Insurers Risk-Select Against Each Other? Evidence from Medicaid and Implications for Health Reform∗

Increasingly in U.S. public insurance programs, the state finances competing, capitated health plans rather than using a fee-for-service (FFS) model. We study how highand low-cost infants (blacks and Hispanics, respectively) are affected by the transition from FFS to Medicaid managed care (MMC). We find that black-Hispanic infant health disparities widen—e.g., black mortality increases by 12% w...

Do Insurers Risk-Select Against Each Other? Evidence from Medicaid Managed Care∗

Medicaid programs increasingly finance competing, capitated managed care plans rather than administering fee-for-service (FFS) programs. We study how the transition from FFS to managed care affects highand low-cost infants (blacks and Hispanics, respectively). We find that blackHispanic disparities widen—e.g., black mortality and pre-term birth rates increase by 15% and 7%, respectively, while ...

The new market in health care: prospects for managed care in Australia.

Most developed countries are experiencing, or moving at full speed, to implement new forms of health delivery based in part on capitation arrangements and stronger accountability of health service providers. Proposals for introduction of capitation or managed care have been advanced in Australia but have attracted strong opposition from the medical profession. This paper reviews the policy issu...