This article explores the extent to which Self-Assessed Health Status (SAH) can contribute to the development of capitation and premium rates by predicting mortality, service use, and service cost in an elderly population in a managed care setting. Those who rated their health as poor were three times as likely to die, and service use and cost were positively associated with those who rated their health as poor. Performance indices based on the ratio of actual-to-expected cost within each SAH category suggest a more aggressive treatment of those who rated their health as poor.