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Exposing the true risks of capitation financed healthcare
1Financial reporting and expense analyst based in Gainesville, Florida, USA.
Abstract:
Many healthcare finance mechanisms involve transferring uncertain costs to healthcare providers in lieu of fixed payments or global capitation. Global capitation violates basic principles of risk management through insurance. Risk-theoretic analysis of capitation shows that risk disaggregation forces efficient providers to become inefficient insurers. Risk-assuming providers face lower profitability and increased exposure to operating losses, and must reduce patient benefits. Global capitation causes inefficiency, increases healthcare costs, and threatens patient-provider relationships.
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