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Editor's Correspondence
April 27, 1998

Capitation Rates and Proprietary Secrets

Arch Intern Med. 1998;158(8):930. doi:

The recent article by Brody and Bonham1 on gag rules and trade secrets correctly points out the need for the medical profession to be vigilant and to ascertain the scientific basis for practice guidelines, even if some third parties deem them "proprietary."

The adequacy of capitation payments represents an additional issue. If physicians accept capitated patients at a rate insufficient to provide adequate care, they will have a powerful incentive to withhold or alter treatment. It is therefore the ethical responsibility of physicians to ensure that the rates for capitated patients are actuarially sound. The assistance of national specialty societies and other consultants will likely be needed because of the complexity of such analyses. It is also likely that third-party insurance carriers will be reluctant to divulge the data behind the rates they are offering to physicians. The carriers will maintain that these data are "trade secrets."

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