Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Capitation risks for pharmacy services.

R P Navarro

    Medical Interface
    |June 7, 1994
    PubMed
    Summary
    This summary is machine-generated.

    Capitated contracts are viable only in select scenarios requiring strong utilization data and provider controls. These agreements demand extreme caution from both buyers and sellers for successful long-term partnerships.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Targeting formulary pull-through strategies: the role of pharmaceutical manufacturers.

    Managed care interface·1999
    Same author

    Internet pharmacies: opportunities and challenges.

    Managed care interface·1999
    Same author

    Raising the bar in the formulary decision process.

    Managed care interface·1999
    Same author

    Influencing drug formulary and contract performance.

    Managed care interface·1999
    Same author

    Cost and quality implications of inappropriate anti-infective use.

    Managed care interface·1999
    Same author

    The effect of managed care on community pharmacy reimbursement.

    Managed care interface·1999
    Same journal

    Interfacing managed care and long-term care: understanding the issues.

    Medical interface·1997
    Same journal

    HIPAA (Health Insurance Portability and Accountability Act) rules: federal and state enforcement.

    Medical interface·1997
    Same journal

    Diabetes management: improving care in HMO and community settings.

    Medical interface·1997
    Same journal

    Why don't we have "better" diabetes care?

    Medical interface·1997
    Same journal

    Opportunities and challenges of electronic physician prescribing technology.

    Medical interface·1997
    Same journal

    Electronic formulary control.

    Medical interface·1997
    See all related articles

    Area of Science:

    • Health economics
    • Pharmacy management
    • Contracting

    Background:

    • Capitation models are increasingly explored for healthcare service reimbursement.
    • Pharmacy benefit management presents unique challenges within capitation frameworks.

    Purpose of the Study:

    • To evaluate the feasibility and limitations of capitated contracts in pharmacy settings.
    • To identify critical success factors and risks associated with pharmacy capitation.

    Main Methods:

    • Analysis of existing capitated contract structures in healthcare.
    • Review of utilization data and provider control mechanisms.
    • Case study examination of pharmacy benefit management contracts.

    Main Results:

    Related Experiment Videos

  • Capitation is generally unsuitable for individual pharmacy reimbursement.
  • Limited applicability exists for manufacturer contracts and integrated health plans (HMOs/PBMCs).
  • Success hinges on historical utilization, provider control, and partner commitment.

    • Conclusions:

    • Capitated contracts for pharmacy services require highly specific conditions to succeed.
    • Careful consideration and risk mitigation are essential for both parties in any capitated arrangement.