Capitation payment: using predictors for medical utilization to adjust rates.
Epstein, Arnold M
Date of Pub
Cumella, Edward J
The current adjusted average per capita cost methodology has been strongly criticized because the subgroup classifications
explain minimal interpatient variation in utilization, therefore providing incentives for biased selection. In this article,
we review previous investigations of predictors of medical utilization that might be included in the adjusted average per
capita cost: perceived health status, functional health status, prior utilization, clinical descriptors, sociodemographic
characteristics, and other miscellaneous patient characteristics. The existing data are analyzed to assess what is known about
the relative strength of various predictors. Gaps in the available literature and the implications for future research and
policy are discussed.
Capitation Fee : Fees and Charges : Aged : Data Collection : Demography : Health Maintenance Organizations/utilization : Health
Status Indicators : Human : Medicare/utilization : Models, Statistical : Probability : Rate Setting and Review : Socioeconomic
Factors : Support, Non-U.S. Gov't : United States