Bazos D A, Fisher E S
Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH, USA.
Eff Clin Pract. 1999 Jan-Feb;2(1):24-9.
The Medicare program has promoted capitation as a way to contain costs. About 15% of Medicare beneficiaries nationwide are currently under capitation, but tremendous regional variation exists.
The proportion of Medicare beneficiaries who have enrolled in risk-contract plans in individual states and in the 25 largest metropolitan areas in the United States.
Health Care Financing Administration data files.
Medicare beneficiaries are most likely to be under capitation in Arizona (38%) and California (37%). Eight other states have capitation rates greater than 20%: Colorado, Florida, Rhode Island, Oregon, Washington, Pennsylvania, Massachusetts, and Nevada. Thirty states, largely in the Great Plains area and the southern United States, have capitation rates less than 10%. Four major metropolitan areas have market penetration rates greater than 40%: San Bernardino, California; San Diego, California; Phoenix, Arizona; and Miami, Florida. Little penetration exists outside of metropolitan areas.
Capitation in Medicare is a regional and predominantly an urban phenomenon.
医疗保险计划将按人头付费作为控制成本的一种方式。目前，全国约15%的医疗保险受益人采用按人头付费方式，但地区差异巨大。
美国各州以及25个最大都市区中参加风险合同计划的医疗保险受益人的比例。
医疗保健财务管理局的数据文件。
亚利桑那州（38%）和加利福尼亚州（37%）的医疗保险受益人采用按人头付费方式的可能性最高。其他八个州的按人头付费率超过20%：科罗拉多州、佛罗里达州、罗德岛州、俄勒冈州、华盛顿州、宾夕法尼亚州、马萨诸塞州和内华达州。30个州（主要位于大平原地区和美国南部）的按人头付费率低于10%。四个主要都市区的市场渗透率超过40%：加利福尼亚州圣贝纳迪诺、加利福尼亚州圣地亚哥、亚利桑那州凤凰城和佛罗里达州迈阿密。大都市区以外的地区渗透率很低。
医疗保险中的按人头付费是一种地区性现象，主要集中在城市。
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