Biomedical subjects

P A Van Loon

Publications and source records attributed to P A Van Loon.

2 recordsLinked to original sources

PubMed1995

The need for integrated risk management in capitated provider groups.

Financial risk is not just ensuring that there is enough capitation revenue to cover claims for services. The changing world of health care is devolving risk and exposures to provider groups that were previously covered by insurance companies, HMOs, and other payers. Capitated providers must first understand the risk they face and then manage it. There is more to be gained in terms of independence than to be feared in additional administrative work.

Actuarial Analysis↗

PubMed1995

Managing underwriting risk in capitated provider groups.

Physicians working under capitated arrangements must provide quality care and make money, i.e., manage the underwriting risk. Sometimes those ends can seem to be contradictory. To use capitation as a tool to provide cost-effective and quality health care, it behooves the physician to know what forces are at work that influence the results of this capitated environment. Several of those areas are under control of the physician directly and others are not. The physician must know what he or she can control and what cannot be controlled.

Capitation Fee↗