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PubMedDate not supplied

Who's minding the data: information system requirements for participating in at-risk contracts.

Managed behavioral healthcare organizations that receive capitated payments to provide behavioral healthcare services for a defined population need sophisticated management information systems that allow for two-way data exchange with payors. Such systems must be able to generate data on cost per service and utilization of services by beneficiary population, while incorporating a number of subsystem capabilities. In this article the author reviews the requirements for such an information system, the various potential financial loss points that have made such capabilities essential and the specific features that are demanded--as well as offering suggestions on how to select an information system vendor.

Capitation Fee↗
PubMedDate not supplied

Behavioral health at-risk contracting--a rate development and financial reporting guide.

The process of developing rates for behavioral capitation contracts can seem mysterious and intimidating. The following article explains several key features of the method used to develop capitation rates. These include: (1) a basic understanding of the mechanics of rate calculation; (2) awareness of the variables to be considered and assumptions to be made; (3) a source of information to use as a basis for these assumptions; and (4) a system to collect detailed actual experience data.

Capitation Fee↗
PubMedDate not supplied

At-risk contracting: preparing to deliver what purchasers want.

Behavioral healthcare organizations wishing to enter the "brave new world" of capitated and at-risk contracting must understand the various categories of healthcare purchasers and risk contracts, as well as the perspectives and goals of those purchasers. The following article also identifies some critical elements in successful at-risk contracting and next steps for providers in such areas as quality improvement, outcomes management and accessibility.

Capitation Fee↗