You will need to consider the treatment profile of the average patient . If patients and referral sources are the same under this contract, as in the past, experience should be a reliable guide. If the plan insists on full risk or nothing, it may be your clue to back away. If you are still considering a capitated agreement, you must honestly decide what opportunities exist for you to practice more efficiently than you have in the past or at least more efficiently than your competitors. If you do not manage patient demand, including the expectations your referral sources give to patients, you can quickly get in trouble.
Demand management is nothing new for specialties like pediatrics.
Not surprisingly, many of them do well under capitation agreements, especially with predictable cash flow replacing the hundreds of small claims they used to bill daily. It s not so simple with oncology. Recommended screenings should be reinforced as well. If, instead, you end up in conflict over whose pool of funds such screenings and work-ups must be paid from, you must then decide if this is the kind of contract you want to accept. All aspects of care must be managed and managed well.