Why Provider Organizations Should be a Proponent of Capitation

Abstract

For the past 35+ years, we have been actively involved in the development, implementation, and operation of health care organizations that have received compensation for services rendered on a prepaid, capitated basis.  As more and more health care organizations embrace the Triple Aim and payors coalesce around provider organizations that are capable of accepting greater levels of professional and institutional risk, the question remains: “Should provider organizations be proponents of capitation?”  How does one assess whether or not capitation can work and, if so, what are the drivers of success that need to be understood and internalized?