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Related Experiment Videos

Capitating home health care.

A Perry1

  • 1Olsten Health Services, Melville, NY, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|February 6, 1998
PubMed
Summary

Managed care is expanding into home health, but capitation contracts are hindered by a lack of cost data and provider control over utilization. Collaboration between home health providers and payers is key for successful capitation.

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Area of Science:

  • Healthcare Management
  • Health Economics
  • Home Healthcare Services

Background:

  • Managed care models are increasingly being adopted within the home health care sector.
  • Home healthcare providers are entering into capitation contracts, shifting financial risk.
  • A significant barrier to successful capitation is the limited availability of cost and utilization data.

Purpose of the Study:

  • To examine the challenges faced by home healthcare providers in managing capitation contracts.
  • To identify the impact of limited data and control over care management on utilization.
  • To explore the necessity of cooperative relationships between providers and payers for successful capitation.

Main Methods:

  • Analysis of the current landscape of managed care in home health.
  • Identification of barriers to effective utilization management under capitation.
  • Conceptual framework for developing cooperative provider-payer relationships.

Main Results:

  • Difficulty in establishing equitable capitation rates due to insufficient cost and utilization data.
  • Home healthcare providers lack sufficient control over care management to effectively manage utilization.
  • Providers are not accustomed to the financial and service-delivery responsibilities of capitation.

Conclusions:

  • Cooperative working relationships between home healthcare providers and payers are essential for success.
  • Developing mechanisms for collecting and sharing necessary data is crucial.
  • Mutual success in capitation arrangements hinges on information exchange and collaborative strategies.

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