A practical method of adjusting for risk in the prospective costs of capitated systems

Article Abstract:

Health services providers and medical groups must be able to accurately project the costs of compensation per member per month since the difference between premium income and administrative and medical expenses determines the profitability of a health plan. A workable model for incorporating risk in projections of the full cost per member per month is proposed. This model enhances the ability of medical groups to evaluate contractual agreements involving capitation rates. It can also improve the evaluation of operating plans and of operating and financial results generated during the contract period.

Methods, Management, Risk assessment, Measurement, Medical care, Cost of, Health care costs, Group medical practice, Risk (Insurance)

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Health care administration in the year 2000: practitioners' views of future issues and job requirements

Article Abstract:

A survey, conducted by the U.S. Army-Baylor University Graduate Program in Health Care Administration, reveals the most important health care administration issues are related to cost/finance, leadership, interaction with staff and health care delivery. The abilities needed to deal with these issues include the interpersonal skills to deal with professionals at all levels, and a particular vision that will lead to an integration of the organization and encourage participation in policy.

Forecasts and trends, Medical care

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