American Psychiatric Association Capitation Handbook: Actuarially Determined Capitation Rates for Mental Health Benefits

In recent years, specialty capitation programs have expanded rapidly. Many HMOs, insurers, and health plans capitate alcohol, drug, and mental disease (ADM) services. Capitation rates paid vary widely, as do the definitions of covered services, managed care practices, and local cost levels. The American Psychiatric Association (APA) commissioned this report to provide its members with guidance in how and why capitation rates may vary. The American Psychiatric Association Capitation handbook provides psychiatrists with a clear-cut actuarial analysis and data to assist those who want to contract on a capitation basis.The Handbook gives psychiatrists a general guidance and education on capitation, capitation rates and how various factors may affect such rates. It presents these factors and offers many examples of how they interact to produce particular capitation rates.