URAC Core 20 -- Financial Incentive Policy -- Capitation

At a recent URAC educational program, the URAC reviewer giving the presentation made it clear that this policy, which requires the organization to ensure that consumer healthcare is not compromised whenever there is compensation based on consumer utilization, includes capitation of providers.  Not all URAC reviewers over the years have interpreted this standard this way, so it is helpful to get official clarification on this sometimes controversial issue.

This becomes more critical now that the 2007 changes are moving into effect this summer: this standard is now a mandatory standard.  Mess it up and there's no Full Accreditation for your organization!