An information system model for negotiating capitation contracts

Capitation contracts require health care organizations to negotiate on a much more sophisticated and risky level. Understanding whether a capitation contract will allow a hospital to remain financially viable while providing quality care requires estimating the number of patients to be served, the a...

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Bibliographic Details
Published in:Physician executive 1998-05, Vol.24 (3), p.38-41
Main Author: Ransom, S B
Format: Article
Language:English
Subjects:
Academic Medical Centers - economics
Academic Medical Centers - organization & administration
Analysis
Capitation Fee
Computer Simulation
Contract Services - economics
Contract Services - organization & administration
Cost Allocation - methods
Economic aspects
Financial Management, Hospital - methods
Health administration
Hospital Bed Capacity, 300 to 499
Hospital Costs
Hospital information systems
Hospital Information Systems - economics
Hospital Information Systems - organization & administration
Hospitals
Information storage and retrieval systems
Managed care plans (Medical care)
Managed Care Programs - economics
Management
Medical Records Systems, Computerized
Michigan
Negotiating
Systems Integration
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Summary:Capitation contracts require health care organizations to negotiate on a much more sophisticated and risky level. Understanding whether a capitation contract will allow a hospital to remain financially viable while providing quality care requires estimating the number of patients to be served, the amount and types of services to be offered, and the cost to provide them. This article presents an information system model designed to assist a large hospital, not only in determining true patient cost, but also in aggregating the cost information in different ways, such as conducting a case-mix analysis, to perform a more informed quote analysis for capitated contracts.
ISSN:0898-2759