Global capitation at a women's health referral center: the challenge of patient selection.

Global risk capitation as a preferred payment method in heavily penetrated managed care markets poses important challenges for women's health care tertiary referral centers that employ participating primary care physicians. Global risk capitation agreements expose those centers to the adverse financial effects of high frequency of obstetric visits, costly infertility and neonatal care, and care of a disproportionate number of patients with complex, resource-intensive conditions.