Supplementing managed competition.
President Clinton's proposal for health care reform calls for managed competition within global expenditure targets. However, it is unlikely that health plans will have sufficient leverage with providers to negotiate arrangements consistent with expenditure targets in nonurban areas. This paper describes a reimbursement system based on competitive prospective payment and capitation (CPPC) which can supplement managed competition in less populous areas or replace managed competition should that strategy prove unsuccessful. The CPPC system is capable of enforcing an expenditure target while encouraging the formation of capitated networks and creating strong incentives for efficiency. It is generally compatible with the Clinton administration's version of managed competition.
Higgins
W
W
Department of Public Health, Western Kentucky University, Bowling Green 42101.
D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D003363:Cost Control; D004465:Economic Competition; D005102:Health Expenditures; D008329:Managed Care Programs / Q000191:economics*; D011445:Prospective Payment System; D013219:State Government; D014481:United States