Capitation In California

Author: Maurice J. Penner
Publisher: Maurice Penner
ISBN: 9781567930511
Size: 31.73 MB
Format: PDF, ePub, Mobi
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This "from-the-trenches" guide can help you meet the challenges of forecasting a population's healthcare needs, building a provider panel, establishing financial incentives for providers, establishing information systems for managed care, ...

The Capitation Sourcebook

Author: Peter Boland
Publisher: Jones & Bartlett Learning
ISBN: 9780965271707
Size: 33.16 MB
Format: PDF
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THE MANAGED cARE world, California is often viewed as an indicator of where
the rest of the nation is headed. In California, capitation rates are as much as 50
to 100 percent lower than those in other states. Many integrated delivery systems
(IDSs) experienced a 3 to 5 percent decline in per member per month (PMPM)
capitation rates in 1995. It is no surprise, then, that only two of the seven leading
California IDSs achieved a return on sales equal to or above the average rate for
all ...

Health Care Policy And Politics A To Z

Author: Julie Rovner
Publisher: CQ Press
ISBN: 1452267324
Size: 70.62 MB
Format: PDF, ePub
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Global capitation makes the capitated entity liable for all care. The theory behind
capitation is that the payments for patients who need little care will offset the
losses for those who need more than the capitated amount, while eliminating the
incentive for practitioners to do more than may be necessary to increase their
income. Critics of capitation Carrier (Medicare) point out that although it
eliminates the. Cafeteria benefits plans California Public Employee Retirement
System ...

California Physician

Size: 61.61 MB
Format: PDF, ePub, Docs
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But they have to translate that unhappiness into patient education. If doctors don't
know how to educate patients, let them read my book. If they agree with the book,
let them recommend it to patients. If doctors would educate their patients and use
the power that they have, I think things would change more quickly than they
would ever expect. Doctors should explain to patients how the system works. I
have a lot of bright patients who have no idea what capitation is. When I explain it
to ...

Improving Managed Health Care In California

Size: 29.57 MB
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1995 AMA physician survey found that PCPs receive a significant share of HMO
reimbursement through capitation, while most specialty care physicians still are
reimbursed on a FFS basis.” The 1995 PPRC report on health plans shows that
the use of capitation arrangements is spreading into the area of specialist
compensation. Although FFS is still the predominant method for paying
specialists, 18% of plans report using capitation as their main method of payment
for individual ...

California Hospitals

Size: 75.49 MB
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Accepting Capitation? Welcome To The Insurance Business! BIOMEDICAL
makes sense as a way for hospitals and health systems to stabilize providet
revenue. But, it also represents one of the biggest risk transfers in history. As
capitated managed care contracts increase, the provider assumes the risk for the
excess capacity. No two risk contracting situations are alike. From contract
administration support to ...

Medical Groups And The Transition To Managed Care In California

Author: Lawrence Peter Casalino
Size: 48.55 MB
Format: PDF
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Along with a small number of other medical groups, they did more than just
respond to changes in their environment: they cooperated with each other and
with HMOs to help create a new industry. In 1979 these five groups had a total of
192 physicians (126 of whom were in the Palo Alto Medical Clinic) and 20,606
HMO enrollees; by 1994 they had 928 physicians and 906,932 HMO enrollees.”
California's HMO industry was and is based on capitation of medical groups (and
of IPAs) by ...

Medicaid Services In California Under Different Organizational Modes

Author: Foline Eppstein Gartside
Size: 45.37 MB
Format: PDF, ePub
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a comparative study of organizational characteristics and their relationships to
the volume, costs, quality and outcomes of services to medicaid beneficiaries
Foline Eppstein Gartside, Carl E. Hopkins, University of California, Los Angeles.
School of Public Health, Milton Irwin Roemer. Table 11. AFDC: Percent of
Physician Visits by Place of Visit The variation in Table 11 in the percentage of
hospital visits may be noted: lowest in the capitation foundation and highest in
the standard ...