Practical implementation of globally priced episodes of care: lessons learned from Oxford's specialty management program.
Globally priced episodes of care afford payers a more efficient method of allocating risk and simultaneously accommodating the now permanent demand for choice and access at the point of service. Foreseeing the trend away from capitated delivery systems, in April of 1996. Oxford Health Plans began to invest considerable resources to implement global fees. When Oxford ran afoul of Wall Street and New York State insurance regulators (for reasons unrelated to the subject of this article), it was forced to abandon the new program. For the growing number of payers interested in pursuing similar contracting strategies, this article may serve as a useful source of information.
Emery
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Zoadigm Health Systems, Inc., Sandy, UT, USA.
D002204:Capitation Fee; D003284:Contract Services / Q000191:economics / Q000458:organization & administration; D004470:Economics, Medical; D017050:Episode of Care; D007357:Insurance, Physician Services; D009518:New York; D019982:Organizational Case Studies; D011320:Primary Health Care / Q000191:economics; D012017:Referral and Consultation; D020414:Risk Sharing, Financial; D012984:Software; D013038:Specialization