PHOs and risk: aligning incentives with internal subcapitation.
Many PHOs have not realized the efficiencies they anticipated when they accepted capitation payments on behalf of their member organizations. Internal subcapitation of professional and facility expenses can promote the organizational alignment of incentives necessary for PHOs to succeed in competitive managed care markets. PHOs may establish subcapitation budgets and corresponding leakage pools to augment efficiency and promote patient access within the PHO. Care should be taken, however, that sufficient resources needed to collect and analyze utilization data, as well as the infrastructure needed to administer subcapitation, are in place.
Sussman
A J
AJ
Brigham & Women's Physician Hospital Organization, Boston, MA, USA.
Fairchild
D G
DG
Brennan
T A
TA
D002017:Budgets; D002204:Capitation Fee / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D003625:Data Collection; D017598:Efficiency, Organizational; D005376:Financial Management; D006759:Hospital-Physician Joint Ventures / Q000191:economics*; D009937:Organizational Objectives; D010816:Physician Incentive Plans; D020414:Risk Sharing, Financial / Q000191:economics*; D014481:United States; D014600:Utilization Review