The Psychiatrist's Guide to Capitation and Risk-Based Contracting / Edition 1

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In today's competitive economic environment, many psychiatrists are entering capitation agreements with managed care organizations. In exchange for a flat fee for each member of a benefit plan, the psychiatrist must provide all services needed by group members regardless of the amount of service required or its cost. The Psychiatrist's Guide to Capitation and Risk-Based Contracting provides the tools that will allow clinicians to navigate this complex process and develop a successful capitated program. It includes an overview of the primary financial, administrative, and clinical issues involved in such a contract. This guide contains helpful advice on how to calculate an equitable capitation rate, evaluate and negotiate a contract, minimize the financial risks involved, and resolve numerous other issues crucial to a successful capitation contract. An interactice mental health capitation demonstration disk especially designed and developed to educate psychiatrists about the interrelationships between mental health utilization, mental health service cost, and managed care capitation rates accompanies this book.

By using this guide, clinicians will be able to manage this competitive environment in the best interests of their patients and their practice.

American Psychiatric Publishing

The book contains two-color illustrations.

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Editorial Reviews

Capitation models currently employed in mental health are presented in this monograph (one of a series of five), along with aspects of developing and managing capitation contracts; and legal, regulatory, and quality issues for capitated psychiatrists. Includes a print/disk worksheet to estimate capitation rate, APA resources and services, a bibliography, and glossary. No index. Annotation c. by Book News, Inc., Portland, Or.
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Product Details

  • ISBN-13: 9780890424537
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 8/28/1997
  • Edition description: BOOK&DISK
  • Edition number: 1
  • Pages: 116
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.25 (d)

Table of Contents

Capitation models currently employed in mental health. Understanding capitation rate development. Evaluating and negotiating a capitation contract. Organizational and administrative issues in managing a capitated contract. Legal and regulatory issues for capitated psychiatrists. The dilemma of quality in capitated systems. Conclusion. Appendix 1: Determination of claim liability: medical vs. psychiatrist claims. Appendix 2: Instructions for using the capitation worksheet to estimate a capitation rate. APA resources and services for psychiatrists working in managed care. Capitation and risk-based contracting bibliography. Capitation and risk-based contracting glossary. Disk with capitation worksheet.

American Psychiatric Publishing

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