A capitation payment arrangement can be an effective means to control health care costs, because it allows both the insurer and the employer to predict costs for health care services more accurately. This article describes a six-step methodology for developing a capitation payment rate and establishing such arrangements. The six steps are: (1) determine the delivery system cost base, (2) develo...

BACKGROUND Ghana introduced capitation payment for primary care in 2012 with the view to containing escalating claims expenditure. This shift in provider payment method raised issues about its potential impact on patient-provider trust relationship and insured-patients' trust in the Ghana National Health Insurance Scheme. This paper presents findings of a study that explored insured-patients' p...

"""THE month of September this year has for panel doctors a peculiar interest. Before the month has run its course the Minister of Health will, it is anticipated, have made up his mind as to the amount of the capitation fee which will be proposed as the rate of the panel doctor's remuneration after the end of the present year. Doctors are refraining from any public discussions on the subject un...

This paper analyzes the effect of capitation payment and patient choice on waiting time and the comprehensive quality of hospital care. The study assumes that two local public hospitals are located in two cities with different population sizes and compete with each other. We find that the comprehensive quality of hospital care as well as waiting time of both hospitals improve with an increase i...

In this article, the risk arrangements in Medicaid programs that put physicians at risk are summarized. These programs--partial capitation and health insuring organizations--pay physicians a capitation amount to cover some or all physician services. Physicians also receive part of the savings from reduced hospitalization. Most of these programs have successfully lowered Medicaid costs. They cou...

General practice prescribing costs have risen rapidly in recent years, and there are wide variations between practices in rates and costs of prescribing. Setting general practice prescribing budgets with a capitation based formula seems to offer a solution to these problems. However, capitation based formulas may unfairly penalise legitimate variations and increases in prescribing costs. We the...

Quality and Quantity in Primary Care Mixed Payment Models: Evidence from Family Health Organizations in Ontario We study the impact of a mixed capitation model known as the Family Health Organization (FHO) on selected quality and quantity outcomes relative to an enhanced fee-for-service model known as the Family Health Group (FHG) among primary care physicians in Ontario, Canada. Using a panel ...

Capitation models have been suggested as an alternative to funding methods based on historical utilization patterns. Capitation funding distributes resources to regions or programs according to their population, adjusted for the age and gender composition and relative need. The most commonly used relative needs measure is the Standardized Mortality Ratio (SMR). This paper compares the distribut...

In the search for greater efficiency and cost-containment, many health systems have introduced the practice of medical care providers operating under a fixed budget, often referred to as the capitation or fundholding contract. Although the capitation contract seems equitable at first glance, the sequential decision-making practice of providers-shaped by their rate of present-preference and thei...