Capitation by David I. Samuels offers a view of capitated managed care. Capitation is classically defined as a method of payment for healthcare services where the provider accepts a fixed amount of payment per subscriber and period of time, for providing specified services of a period of time. The author considers rationally managed systems of capitated managed care as offering a broader and improved health status and health management around the world. Capitated managed care is important since the U.S. healthcare delivery system is moving in its direction and by the year 2000 capitated managed care will become the predominant payor source. Understanding the capitated managed care marketplace determines the ability of healthcare providers and enterprises to remain in business.
Managed care is viewed as a concept that is not going to go away, however the term managed care is overused and thought to apply only to managing costs. Capitated managed care goes beyond these limitations. The understanding of managed care is confused by the use of jargon in the healthcare delivery system. Managed care is understood differently within the public and private sectors.
Private sector views managed care as the means of providing healthcare services within a defined network of providers who are responsible for managing and providing high-quality, cost-effective healthcare. In this situation providers are not given the information or the means needed to manage a population; rationing becomes a management strategy of last resort. The public-sector understanding of managed care includes efforts to mobilize healthcare services to improve the care of underserved populations (managed caring). The author states that managed care can only work if the public and private sectors join forces to mobilize cost-effective and quality-appropriate solutions.
Capitation has emerged within the healthcare system; the HM
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