Capitation and risk adjustment have become the chosen policy instruments to seek cost containment and equity of access for many developed health care systems. Increasingly, this entails the prospective setting of global budgets for the health care expenditures incurred by health care plans on behalf of their members. Methods of deriving such budgets are diverse and tailored to the specific circumstances of the health care system they seek to serve. This special issue presents a collection of papers devoted to issues surrounding the rationale, derivation, and implementation of capitation and risk adjustment methods of financing health care. These are discussed within the context of health care systems in eight countries, illustrating the range of interest in the topic. Undoubtedly, capitation and risk adjustment will become increasingly significant elements of virtually all systems of health care and we hope the collection of papers will help to stimulate further debate and research in this important and interesting area of health care financing.