Blended Payment Methods in Physician Organizations Under Managed Care

Article Abstract:

Many independent practice associations (IPAs) are combining capitation payments with fee-for-service payments. An IPA is a group of doctors who contract their services to managed care organizations but have some independence in how they manage their practice. Before managed care came along, all doctors billed for their services depending on the service provided. This is called a fee-for-service arrangement. Capitation means the doctor gets paid a specific amount every month for each patient regardless of the service provided. A survey of 7 large IPAs in the San Francisco Bay Area found that most are combining both payment methods.

Management, Usage, Compensation and benefits, Physicians, Medical professions, Health maintenance organizations, Capitated payment systems (Medical care)

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Decline in hospital utilization and cost inflation under managed care in California

Article Abstract:

The role of the hospital in America is changing as managed care reduces hospital use in favor of outpatient services and other non-hospital-based forms of health care. Between 1983 and 1993, managed care organizations in California reduced the rise in health care expenditures among 318 hospitals by 38%. This occurred primarily because fewer patients were admitted to hospitals and those who were had shorter stays. In addition, the number of hospital services provided to patients decreased. A reduction in hospital beds accounted for only 6% of the drop in costs.

Analysis, Economic aspects, Medical care, Cost of, Health care costs, Hospital utilization

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The End of Managed Care

Article Abstract:

Managed care is changing as doctors, patients, and employers experience frustration with the system. In the near future, consumerism may drive the health care industry.

Innovations

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