Medicaid primary care services in New York State: Partial capitation vs full capitation

Journal of Family Practice

Volumn 42, Issue 4, 1996, Pages 362-368

  Rosenthal, Thomas C ^a   Horwitz, Mary E ^a   Snyder, Gregory ^a   O'Connor, Jack ^b  

^a UNIVERSITY AT BUFFALO   (United States)

^b Erie County ^*  (United States)

Author keywords

capitation; insurance, health, reimbursement; managed care; Medicaid; primary health care

Indexed keywords

ARTICLE; COST CONTROL; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HEALTH SERVICE; MEDICAID; MEDICAL FEE; PRIMARY MEDICAL CARE; UNITED STATES;

CAPITATION FEE; COST SAVINGS; HEALTH MAINTENANCE ORGANIZATIONS; MEDICAID; NEW YORK; PRIMARY HEALTH CARE; STATE HEALTH PLANS; UNITED STATES;

EID: 0029878082     PISSN: 00943509     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (34)

1. Hurley RE, Fennell ML. Managed-care systems as governance structures: a transaction-cost interpretation. In: Mick S, ed. Innovations in health care delivery. San Francisco, Calif: Jossey Bass, 1990
2. New York State Managed Care Plan. Albany, NY: New York State Department of Social Services, October 1, 1991.
3. Hurley RE. Status of the Medicaid competition demonstrations. Health Care Finance Rev 1986; 8:65-75.
4. Eisenberg JM. A decade of physician payment reform. Acad Med 1995; 70:126-7.
5. Rasell ME. Cost sharing in health insurance, a reexamination. N Engl J Med 1995; 332:1164-8.
6. Iglehart JK. Health policy report: the American health care system, Medicaid. N Engl J Med 1993; 328:896-900.
7. Davis K, Rowland D. Financing health care for the poor. In: Eli Ginsberg, ed. Health services research: key to health policy. Cambridge. Mass: Harvard University Press, 1991.
8. Sullivan LW. Interim report to Congress: patterns of health care utilization in the nonelderly Medicaid population of selected states. Baltimore, Md: Health Care Financing Administration, 1992.
9. Omnibus Budget Reconciliation Act (OBRA), 1981. PL 93-35.
10. Fisher RS. Medicaid managed care: the next generation? Acad Med 1994; 69:317-22.
11. Shenkel RC. Medicaid miracle in the mountains. Fam Pract Manage 1994:45-8.
12. Buchanan IL, Leibowitz A, Keesey J, Mann J, Damberg C. Cost and use of capitated medical services: evaluation of the program for prepaid managed care. Santa Monica, Calif: Rand Corporation, 1992. (R-422S-HCFA).
13. New York State Department of Social Services. Medicaid managed care: annual report. Albany, NY: New York State Managed Care Program Advisory Council, September 1994.
14. Schulz R, Girard C, Scheckler WE. Physician satisfaction in a man aged care environment. J Fam Pract 1992; 34:298-304.
15. Loeffler RT. Measuring quality of care in physicians' offices. J Ambulatory Care Manage 1992; 15:62-8.
16. Greenfield S, Nelson EC, Zubkoff M, et al. Variations in resource utilization among medical specialties and systems of care: results from the Medical Outcomes Study. JAMA 1992; 267:1624-30.
17. Starfield B, Powe NR, Weiner JR, Stuart M, Steinwachs D, Hudson Scholle S, Gerstenberger A. Costs vs quality in different types of primary care settings. JAMA 1994; 272:1903-8.
18. Fanning T, de Alteriis M. The limits of marginal economic incentives in the Medicaid program: concerns and cautions. J Health Polit Policy Law 1993; 18:27-42.
19. Perloff JD, Kletke P, Fossett JW. Which physicians limit their Medicaid and why. Health Serv Res 1995; 30:7-26.
20. Weeks WB, Wallace AH, Wallace MM, Welch HG. A comparison of the educational costs and incomes of physicians and other professionals. N Engl J Med 1994; 330:1280-6.
21. Mark DB, Naylor CD, Hlatky MA, et al. Use of medical resources and quality of life after myocardial infarction in Canada and the United States. N Engl J Med 1994; 331:1130-5.
22. Ayanian JZ, Hauptman PJ, Guadagnoli E, Antman EM, Pashos CL, McNeil BJ. Knowledge and practices of generalist and specialist physicians regarding drug therapy for acute myocardial infarction. N Engl J Med 1994; 331:1136-42.
23. Franks P, Clancy CM, Nutting PA. Gatekeeping revisited-protecting patients from overtreatment. N Engl J Med 1992; 327: 424-9.
24. Roos NP. Who should do the surgery? Tonsillectomy-adenoidectomy in one Canadian province. Inquiry 1979; 16:73-83.
25. Singh BM, Holland MR, Thorn PA. Metabolic control of diabetes in general practice clinics: comparison with a hospital clinic. BMJ 1984; 289:726-8.
26. Shortell SM, Vahovich SG. Patient referral differences among specialties. Health Serv Res 1975; Summer 146-61.
27. Rosenthal TC, Riemenschneider TA, Feather J. The changing generalist/specialist interaction under managed care. Am J Med 1996; 100.
28. Freund DA, Hurley RE. Managed care in Medicaid: selected issues in program origins, design, and research. Annu Rev Public Health 1987; 8:137-53.
29. Temdin-Greener H, Winchell M. Medicaid beneficiaries under managed care: provider choice and satisfaction. Health Serv Res 1991; 26:509-29.
30. Blumenthal D, Mort H, Edwards J. The efficacy of primary care for vulnerable population groups. Health Serv Res 1995; 30:253-73.
31. Ware JE, Prook RH, Rogers WH, et al. Comparison of health outcomes of a health maintenance organization with those of fee-for-service care. Lancet 1986; 1:1017-22.
32. Horwitz ME, Wysong JA, James PA, Rosenthal TC. Health care reform for rural Medicaid: finding solutions with limited resources. Working paper No. 4. Buffalo, NY: New York Rural Health Research Center, July 1994.
33. Christianson JB. Alternative delivery systems in rural areas in a rural health services agenda. Health Serv Res 1989, 23:853.
34. Shouldice RG. Introduction to managed care. Arlington, Va: Information Resources Press, 1991.