The inclusion of capitation reimbursement in solo practice

Capitation reimbursement has been an integral part of prepaid group practices in both medicine and dentistry, and claims have been made for its ability to influence the delivery of services favorably. Experts have suggested that if capitation is implemented, more preventive care will be provided, more diagnostic services will be provided, there will be better continuity of care, utilization of high-cost services will be reduced, and clinical outcome will be improved. This study focused on the dominant mode of practice in dentistry, the general, solo practitioner, to determine if these contentions held. A sample of 245 patients whose care was paid for by a capitation mechanism was matched to a sample of 245 similar patients whose care was paid for on a standard fee-for-service basis--all from three dentists' practices. All services in all years of care for each patient were analyzed. It was determined that the rate of restorations was lower, while rates of diagnostic testing and prophylaxis were higher for capitation patients. Continuity was also better under capitation, but rates of extractions were virtually identical for the two groups.