Capitation scored major wins last fall when two of eight health plans agreed to settle longstanding antitrust charges with physicians. See how at-risk physicians benefit.
Capitation scored major wins last fall when two of eight health plans agreed to settle longstanding antitrust charges with physicians. See how at-risk physicians benefit.
When capitated doctors are sued for non-referral to specialists, typical charges include that the capped network's PMPM rates served as a disincentive to refer. So far none of the charges have prevailed. Physicians also are winning lawsuits alleging inadequate capitation rates from HMOs.