Capitation Payment and Mental Health Care: A Review of the Opportunities and Risks

Capitation as a method of health care reimbursement has grown dramatically during the past two decades and may have a marked impact on funding for mental health services in coming years. The author defines capitation within the context of various health care reimbursement approaches, presents arguments for and against capitation, reviews the record of capitation for general medical care, and discusses proposals for capitation systems for high-risk patient groups. The potential benefits and risks of capitating mental health services for the general population and for high-risk groups are explored, and initial activities to develop a capitation system for chronic patients in two New York counties are described.