Bringing managed care incentives to Medicare's fee-for-service sector.
The Health Care Financing Administration (HCFA) could work with eligible physician organizations to generate savings in total reimbursements for their Medicare patients. Medicare would continue to reimburse all providers according to standard payment policies and mechanisms, and beneficiaries would retain the freedom to choose providers. However, implementation of new financial incentives, based on meeting targets called Group-Specific Volume Performance Standards (GVPS), would encourage cost-effective service delivery patterns. HCFA could use new and existing data systems to monitor access, utilization patterns, cost outcomes and quality of care. In short, HCFA could manage providers, who, in turn, would manage their patients' care.
Tompkins
C P
CP
Institute for Health Policy, Heller Graduate School, Brandeis University, Waltham, MA 02254, USA.
Wallack
S S
SS
Bhalotra
S
S
Chilingerian
J A
JA
Glavin
M P
MP
Ritter
G A
GA
Hodgkin
D
D
D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D003363:Cost Control; D018588:Fee-for-Service Plans / Q000191:economics* / Q000706:statistics & numerical data; D005102:Health Expenditures; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data; D016345:Medicare Part B / Q000191:economics / Q000458:organization & administration*; D012052:Reimbursement, Incentive; D015895:Relative Value Scales; D014481:United States; D014600:Utilization Review