Specialist capitation improves specialty and primary care physician relationships.
Physicians involved in managed care contracting serve as gatekeepers to manage their patients' care and receive payments through capitation arrangements. In serving as gatekeepers, primary care physicians assume financial risk for patients' care. A growing number of specialists, however, are entering into specialist capitation contracts, thereby sharing financial risk and patient care responsibilities. Primary care and specialist physicians should understand the terms of capitation contracts and develop positive working relationships to coordinate efficient, cost-effective patient care. Capitation contracts should define roles and responsibilities of primary care physicians and specialists and should delineate capitated payment rates. When primary care physicians and specialists share financial risk and divide responsibilities, patient care can be managed to the satisfaction of providers, payers, and patients.
Brannen
T J
TJ
Blue Cross Blue Shield of New Hampshire, Manchester, USA.
D002204:Capitation Fee; D003361:Cost Allocation; D004470:Economics, Medical; D005069:Evaluation Studies as Topic; D007400:Interprofessional Relations; D008329:Managed Care Programs / Q000191:economics*; D010821:Physicians, Family / Q000191:economics*; D010818:Practice Patterns, Physicians'; D011907:Rate Setting and Review / Q000379:methods; D012017:Referral and Consultation; D012308:Risk Management / Q000379:methods; D013038:Specialization; D014481:United States