A capitated plan's margin that arrives within months cannot come from disease prevented, because prevented disease takes years to pay.

The claim

The speed of a capitated plan's return is diagnostic of where the return came from. Devoted Health's consolidated medical expense ratio is improving year over year (its state statutory filings, as reported by Endpoints News for 2024), while its membership grew from 212,000 in December 2025 to 538,000 in September 2026 (Devoted, 1 October 2026). A margin booked within months of membership more than doubling cannot be a return on members not developing disease over years, because that return has not had time to arrive. It is consistent with reduced utilisation among members who already have disease, which is where every prior alternative-payment evaluation also found its savings.