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Abstract

Capitation and managed care have created new liability risks for home care providers. The change from fee- for-service to capitated home care delivery reverses economic incentives for providers and gives rise to worrisome conflicts of interest. Unlike fee for-service delivery, capitation has an inherent incentive to underserve the home care patient. Increased contractual linkages, characteristic of managed care, will result in expanded liability. Market trends include acute facilities discharging sicker patients earlier and providers attempting riskier procedures at home. Overall, managed care and capitation offer seductive advantages for home care providers, but bring with them new and serious exposures to liability.

Keywords

capitation fee-for-service delivery liability risks managed care

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Liability Risks for Home Health Care Providers under Managed Care Arrangements

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