Physician's Capitation Trend-Questions to pose when tackling capitation
Physician's Capitation Trend-Questions to pose when tackling capitation
Capitation typically brings greater overhead costs rather than lower costs, says Lisa E. Pieper, co-project manager of the Medical Group Management Association's (MGMA) annual cost survey of physician practices. The public perception that managed care cuts back on services to patients makes capitation pressures even harder to swallow for physicians when they learn that their practice costs can increase with managed care. Patients get less care and physicians lose income? Not a great combination.
Shortly after releasing their annual survey, the Englewood, CO-based MGMA released an advisory, or "self-assessment" worksheet on key aspects of practice performance. Here are highlights of questions they recommend physicians ask regarding the tough issues of cost, practice patterns, productivity, and managed care participation:1
• Are physicians in the practice involved in addressing clinical variation?
• Are practice guidelines, disease management and similar clinical programs that promote preventive care in place?
• Are physicians involved and committed to program goals?
• Are physicians educated routinely in managed care, capitation, and other important features of insurance systems?
• Has your system established performance expectations in connection with compensation?
• Has physician productivity been benchmarked?
• Do physicians know where they stand in relation to benchmark norms?
• Are physicians compensated in relation to production, based on market norms, or both?
• Are physicians rewarded for performance?
• Does the compensation system contain incentives for contributing to organizational success?
• Do physicians understand system expectations?
• Are physicians included in these key decisions?
• Has an operational assessment been conducted to identify areas needing improvement?
• Were all practice sites reviewed?
• Have improvement recommendations been implemented?
• Have all other opportunities for improvement been explored, including standardization and consolidation of practices with excess capacity?
Reference
1. Medical Group Management Association. Practice Solutions. Englewood, Co; 1999.
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