NEGOTIATE SEPARATE CAPITATION RATES FOR SENIOR CITIZENS

The age/sex mix of patients you see under a managed care plan will affect both the capitation rate and your costs in providing care. It will cost you two to four times more to care for senior members of a plan.

Definition

When negotiating capitation contracts, you will generally deal with two capitation rates. The first is known as the commercial rate and covers all patients under 65 years of age. The second, Medicare or Senior Rate, covers patients 65 years of age and older.