Realizing the financial benefits of capitation arbitrage

By anticipating the arbitrage potential of cash flow under budgeted capitation, healthcare organizations can make the best use of cash flow as a revenue-generating resource. Factors that determine the magnitude of the benefits for providers and insurers include settlement interval, withhold amount, which party controls the withhold, and incurred-but-not-reported expenses. In choosing how to structure these factors in their contract negotiations, providers and insurers should carefully assess whether capitation surpluses or deficits can be expected from the provider. In both instances, the recipient and magnitude of capitation arbitrage benefits are dictated largely by the performance of the provider.