Information management for managed care.
A key concern for medical groups is how to manage information in a dual environment of capitation and fee for service. Information systems that work for one may not work for the other. Finding a system that works for both is critical. Some of the data that would be beneficial to collect for starting managing capitation contracts include: age/sex ratios of the practice patient population, average number of visits per patient per year, average number of visits by ICD-9 code for total population, average procedures per patient per year, and analysis of paverage payment per visit/procedure for commercial and Medicare patients. Some of the major concerns addressed include operational issues, financial viability and automated billing systems.
O'Connor
K
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Contultants Medical Group Inc., Oakland, CA 94609, USA.
D002204:Capitation Fee; D003625:Data Collection; D018588:Fee-for-Service Plans; D006123:Group Practice / Q000191:economics / Q000458:organization & administration*; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D008331:Management Information Systems / Q000592:standards*; D016347:Medical Records Systems, Computerized / Q000592:standards*; D011216:Practice Management, Medical / Q000191:economics; D014481:United States / Q000453:epidemiology; D014600:Utilization Review