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Title
Pricing strategies for capitated delivery systems.
First Author
Gruenberg, Leonard
Date of Pub
1986 Supp.
Pages
35-44
Volume
Supp.
Issue
N/A
Other Authors
Tompkins, Christopher P; Wallack, Stanley S
Abstract
This article discusses alternative methods for establishing a fairer pricing mechanism for Medicare recipients who enroll in health maintenance organizations and other competitive medical plans. The current method, based upon the adjusted average per capita cost, is inadequate because it fails to adjust premium levels for differences in health status; it establishes undesirable incentives that may lead to underservice, and it is tied to costs in the fee-for-service system. Alternative methods would incorporate health status, have Medicare share the risk with HMO's, and base payment on HMO experience.
Abstract Continued
N/A
MeSH
Capitation Fee : Fees and Charges : Reimbursement Mechanisms : Aged : Health Maintenance Organizations/economics : Human : Medicare/economics : Models, Theoretical : Rate Setting and Review/methods : United States : United States Health Care Financing Administration
NTIS Number
PB88-131552