Managed Health Care in the New Millennium
Innovative Financial Modeling for the 21st Century
David I. Samuels
EthiCare Breakthrough Solutions/EthiCare Revenue Cycle Management Inc., Las Vegas, Nevada,
USA
ISBN: 978-1-4398-4030-6, December 2011, c. 296 pp.
Thoroughly exploring how capitation has evolved domestically and internationally
in recent years, this book discusses actuarial assumptions and the difficulties in payers'
transitions from community-based underwriting to experience-based ratings. It
explores what the future holds in the areas of clinical pathways and population-based
risk assumption tools and approaches. It covers what happens when the
underlying actuarial and risk assumptions are ignored or trivialized. The author also
discusses the challenges capitation-based pricing faces from an international perspective, including Latin
America and the Caribbean.