Declining welfare caseloads may lead to a sicker population remaining in the Medicaid program, which could increase per enrollee costs and the level of adequate capitation rates. Using data from the 1997 National Survey of America's Families for adults and children, we examine differences in health status and utilization among welfare recipients and welfare leavers who did and did not retain Me...

We model a system akin to the British National Health Service (NHS), in which general practictioners (GPs) are paid by capitation from general taxation. GPs are horizontally and vertically differentiated and compete for patients via their imperfect observed quality. We show that for any given capitation fee quality is lower and the incentive effects of the fee on quality are smaller when there ...

This article addresses a new initiative of the Health Care Financing Administration (HCFA) to contract on a group basis with: employer self-insurance plans, unions, group health insurance companies, and Taft-Hartley Health and Welfare Funds for groups of Medicare beneficiaries. under this new concept, Medicare beneficiaries may elect in the future to obtain Medicare coverage through their group...

This paper explores whether big data, taking the form of extensive high dimensional records, can reduce cost adverse selection by private insurers in government-run capitation schemes, such as Medicare Advantage. We argue that using data to improve ex ante precision regressions is unlikely be helpful. Even if types become essentially observable, dimensionality covariates makes it infeasible pre...

OBJECTIVE To evaluate the predictive accuracy of the Diagnostic Cost Group (DCG) model using health survey information. DATA SOURCES/STUDY SETTING Longitudinal data collected for a sample of members of a Dutch sickness fund. In the Netherlands the sickness funds provide compulsory health insurance coverage for the 60 percent of the population in the lowest income brackets. STUDY DESIGN A de...

OBJECTIVE To assess the responses to financial incentives after a change in the payment system in a capitation-style healthcare payment system over a 5-year period. STUDY DESIGN Cross-sectional and longitudinal examination of cost, utilization, and diagnostic data. METHODS Using Veterans Health Administration (VHA) administrative data on healthcare users between fiscal years 1998 and 2002, ...

In Ireland, approximately 30% of the population receive free GP services (medical card patients) while the remainder (private patients) must pay for each visit. In 1989, the manner in which GPs were reimbursed by the State for their medical card patients was changed from fee-for-service to capitation while private patients continued to pay on a fee-for-service basis. Concerns about supplier-ind...

An unusual combination of facial and cervical trauma was evaluated. The MR findings are reported to describe possible complications of capitation.

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. ...