In a more mature market, physicians begin to examine each HMO contract to compare capitation received from one HMO to another. This may lead to consolidation by physicians of the HMOs in which they participate to maximize revenue. Sales Physicians may begin to consider discounting participation in an HMO if its growth flattens or the capitation received becomes less appropriate in proportion to the costs of providing care. For capitation, it is not how many deals you sign, it is the potential profitability of the contract. Regular reviews of the key performance indicators in each of these areas can help identify potential problems and facilitate action to mitigate financial loss.
Information is crucial to good management.
Another important issue for risk taking entities is to create a framework to analyze if managed care contracts are within expectations.