Where the same HMOs each capitate
the same provider organizations, variability in access to care performance among HMOs could decrease because the same physician organizations may serve enrollees from each HMO.
It's one that is superbly aligned with our business goals of building a post- acute healthcare system in key geographic areas in order to capitate
payment for all post-acute care patients.
There is some doubt in my own mind that HMOs or employers feel that they have sufficiently benefited from the gross waste in the system to make it necessary to capitate
specialists first, eases in PCPs to ensure long-term success of global caps
The health plan that capitates
providers needs to maintain stop-loss insurance and have in its contract with providers specific details of the level of costs for any individual patient and of the aggregate costs of all patients over which costs will no longer be charged against the risk pool.