Paying physicians by capitation: Is the past now prologue?

Health Affairs

Volumn 29, Issue 9, 2010, Pages 1661-1666

  Zuvekas, Samuel H ^a   Cohen, Joel W ^b  

^a AGENCY FOR HEALTHCARE RESEARCH AND QUALITY   (United States)

^b Center for Financing Access and Cost Trends   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH CARE COST; HEALTH MAINTENANCE ORGANIZATION; HUMAN; INCENTIVE SPIROMETER; PHYSICIAN INCOME; PRIMARY MEDICAL CARE; RISK FACTOR; SALARY;

CAPITATION FEE; COST SAVINGS; HEALTH EXPENDITURES; HEALTH MAINTENANCE ORGANIZATIONS; HUMANS; OFFICE VISITS; UNITED STATES; UNITED STATES AGENCY FOR HEALTHCARE RESEARCH AND QUALITY;

EID: 84870429452     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2009.0361     Document Type: Article

References (27)

1. Robinson JC. Theory and practice in the design of physician payment incentives. Milbank Q. 2001;79(2): 149-77.
2. Selden TM. A model of capitation. J Health Econ. 1990;9(4):397-409.
3. Pham HH, Ginsburg PB. Unhealthy trends: the future of physician services. Health Aff (Millwood). 2007; 26(6): 1586-98.
4. Kahn CN III. Payment reform alone will not transform health care delivery. Health Aff (Millwood). 2009; 28(2): w216-8.
5. Mechanic RE, Altman SH. Payment reform options: episode payment is a good place to start. Health Aff (Millwood). 2009;28(2):w262-71.
6. Freudenheim M. H.M.O. scope with a backlash on cost cutting. New York Times. 1996 May 19; Sect. A:1.
7. InterStudy. The InterStudy Competitive Edge 12.1, part II: HMO industry report. St. Paul (MN): Inter-Study; 2002.
8. HealthLeaders/InterStudy. Managed market surveyor [CD-ROM]. St. Paul (MN): HealthLeaders/InterStudy; 2007 Jan.
9. Kaiser Family Foundation. United States, total HMO enrollment, July 2009 [Internet]. Menlo Park (CA): KFF; 2009 Jul [accessed 2010 Aug 3]. Available from: http://www .statehealthfacts.org/profileind.jsp? ind=348&cat=7&rgn=1. These data presented in StateHealthFacts.org are from HealthLeaders/InterStudy.
10. Super N. From capitation to fee-forservice in Cincinnati: a physician group responds to a changing marketplace. Health Aff (Millwood). 2006;25(1):219-25.
11. Robinson JC. Physician organization in California: crisis and opportunity. Health Aff (Millwood). 2001;20(4): 81-96.
12. Zuvekas SH, Cohen JW. Trends in provider capitation, 1996-2000. J Econ Soc Meas. 2005;30:145-56.
13. Strunk BC, Reschovsky JD. Kinder and gentler: physicians and managed care, 1997-2001. Washington (DC): Center for Studying Health System Change; 2002. (Tracking report; no. 5).
14. Fang H, Rizzo JA. The changing effect of managed care on physician financial incentives. Am J Manag Care. 2008;14(10):653-60.
15. American Medical Association. Physician socioeconomic statistics. 2003 ed. Chicago (IL): AMA; 2003.
16. Gold MR, Lake T, Hurley R, Sinclair M. Financial risk sharing with providers in health maintenance organizations. Inquiry. 1999;39: 34-44.
17. Sack K. Massachusetts faces costs of big health care plan. New York Times. 2009 Mar 16; Sect. A:12.
18. Goldsmith J. Analyzing shifts in economic risks to providers in proposed payment and delivery system reforms. Health Aff (Millwood). 2010;29(7):1299-304.
19. Berenson RA, Rich EC. U.S. approaches to physician payment: the deconstruction of primary care. J Gen Intern Med. 2010;25(6):613-8.
20. Rosenthal MB, Landon BE, Normand SL, Frank RG, Epstein AM. Pay for performance in commercial HMOs. N Engl J Med. 2006;355(18): 1895-902.
21. Stagnitti M, Beauregard K, Solis A. Design, methods, and field results of the Medical Expenditure Panel Survey Medical Provider Component (MEPS MPC): 2006 calendar year data. Rockville (MD): AHRQ; 2008 Nov. (MEPS methodology report; no. 23).
22. The Technical Appendix can be accessed by clicking on the Technical Appendix link in the box to the right of the article online
23. Sample sizes of physician office visits with complete information on whether the visits were covered under capitation or fee-for-service arrangements were 24,309, 25,063, 22,794, 22,933, 33,425, 51,797, 46,386, 47,623, 61,901, 58,140, 46,359, and 45,802 for the years 1996-2007
24. We used state-specific weights available for the twenty-nine largest states, with additional adjustments for differential sampling and nonresponse in the MEPS physician survey. For additional details, see Sommers P. Producing state estimates with the Medical Expenditure Panel Survey, Household Component. Rockville (MD): AHRQ; 2005 Dec. (MEPS methodology report; no. 16).
25. Robinson JC. Blended payment methods in physician organizations under managed care. JAMA. 1999; 282(13):1258-63.
26. Trisolini M, Aggarwal J, Leung M, Pope G, Kautter J. The Medicare Physician Group Practice demonstration: lessons learned on improving quality and efficiency in health care. New York (NY): Commonwealth Fund; 2008 Feb.
27. Robinson JC, Shortell SM, Rittenhouse DR, Fernandes-Taylor S, Gillies RR, Casalino LP. Qualitybased payment for medical groups and individual physicians. Inquiry. 2009;46(2):172-91