Rosenstein D I, Cogan G L, Joseph L P
Community Dent Oral Epidemiol. 1980 Oct;8(7):351-4. doi: 10.1111/j.1600-0528.1980.tb01306.x.
The percentage of consumers in the U. S. covered by dental insurance has increased dramatically over the last 10 years. As dental insurance grows, it is becoming increasingly important to examine the context of dental care payment systems. At present, almost all insurance programs are geared toward the fee-for-service system, which reimburses dentists a fixed sum for each type of procedure. The exceptions to fee-for-service dental insurance plans are few. A capitation program for dental care, which reimburses dentists a fixed amount per enrolled patient regardless of services rendered, offers many advantages for both consumers and providers and should be available as an option. Network capitation represents a new approach to the payment of dental care. A network capitation program is being developed in the United States and will use an approach involving two contracts, one which will be used with an insurance company, and the second with a network of private practitioners. The insurance company will supply dental practices with dental patients and funds on a capitation basis. Patients will be given the choice of fee-for-service or capitation. Network capitation allows fee-for-service solo or group practitioners to incorporate capitation patients into their practice.
在过去10年里，美国拥有牙科保险的消费者比例急剧上升。随着牙科保险的发展，审视牙科护理支付系统的背景变得越来越重要。目前，几乎所有保险项目都面向按服务收费系统，该系统会为每种类型的诊疗程序向牙医报销固定金额。按服务收费的牙科保险计划的例外情况很少。一种牙科护理的人头费项目，即无论提供何种服务，都按每位参保患者向牙医报销固定金额，对消费者和提供者都有很多好处，应该作为一种选择提供。网络人头费代表了一种支付牙科护理费用的新方法。美国正在开发一种网络人头费项目，该项目将采用涉及两份合同的方法，一份合同将与保险公司签订，另一份合同将与私人执业医生网络签订。保险公司将按人头向牙科诊所提供牙科患者和资金。患者将可以选择按服务收费或人头费模式。网络人头费允许按服务收费的个体或团体执业医生将人头费患者纳入他们的业务中。
