Managed care capitation contracts have grown in complexity as both payers and providers seek risk sharing arrangements that are based upon a detailed understanding of the risks involved, as well as the ability to manage those risks. Capitation rates must reflect not only the detailed service categories for which risk is transferred, but also the demographic and risk characteristics of the covered population.

APEX consultants have the experience and the sophisticated pricing tools with which to provide accurate capitation rate analysis, for both medical provider and health plan clients. Using our extensive database and pricing software - along with client data when appropriate - we develop primary, specialty, and global capitation rates that vary according to the client's plan design, unit costs, and population demographics.