Capitation. Theory, practice, and evaluating rates for gastroenterology.
Capitation risk contracting has the potential to combine insurance functions with medical care functions. Success depends on a careful consideration of the capitation rate and a thorough understanding of all capitation contract issues. Proper incentives to physicians in a specialty network stimulate a major reengineering effort to squeeze the inefficiency out of the system. Within the network, true peer review can effectively diminish variability in medical care. Such variability leads to increased cost without benefit to health status. The superior medical management of a capitated specialty network can create added value by coordinating more cost-effective and appropriate evaluation and therapy.
Weinstein
M L
ML
George Washington University Medical Center, Potomac, Maryland, USA.
D002204:Capitation Fee / Q000706:statistics & numerical data; D003627:Data Interpretation, Statistical; D005762:Gastroenterology / Q000191:economics*; D015276:Health Care Rationing / Q000191:economics*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics*; D006278:Medicare / Q000191:economics; D008962:Models, Theoretical; D017008:Negotiating; D015397:Program Evaluation / Q000191:economics*; D014481:United States