The future of capitation - The physician role in managing change in practice

Citation
Jd. Goodson et al., The future of capitation - The physician role in managing change in practice, J GEN INT M, 16(4), 2001, pp. 250-256
Citations number
60
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
JOURNAL OF GENERAL INTERNAL MEDICINE
ISSN journal
0884-8734 → ACNP
Volume
16
Issue
4
Year of publication
2001
Pages
250 - 256
Database
ISI
SICI code
0884-8734(200104)16:4<250:TFOC-T>2.0.ZU;2-6
Abstract
Capitation-based reimbursement significantly influences the practice of med icine. As physicians, we need to assure that payment models do not jeopardi ze the care we provide when we accept higher levels of personal financial r isk. In this paper, we review the literature relevant to capitation, consid er the interaction of financial incentives with physician and medical risk, and conclude that primary care physicians need to work to assure that capi tated systems incorporate checks and balances that protect both patients an d providers, We offer the following proposals for individuals and groups co nsidering capitated contracts: (1) reimbursement for primary care physician s should recognize both individual patient encounters and the administrativ e work of patient care management; (2) reimbursement for subspecialists sho uld recognize both access to subspecialty knowledge and expertise as well a s patient care encounters, but in some situations, subspecialists may provi de the majority of care to individual patients and will be reimbursed as pr imary care providers; (3) groups of physicians should accept financial risk for patient care only if they have the tools and resources to manage the c are; (4) physicians sharing risk for patient care should meet regularly to discuss care and resource management; and (5) physicians must disclose the financial relationships they have with health plans and medical care organi zations. and engage patients and communities in discussions about resource allocation. As a payment model, capitation offers opportunities for primary care physicians to influence the future of health care by improving the ma nagement of resources at a local level.