P&T
Our
Other
Journal
MediMedia Managed Markets
Managed Care

 

Scheme Capitates Specialist But Not Primary Doctor

MANAGED CARE January 1999. © MediMedia USA
News and Commentary

Scheme Capitates Specialist But Not Primary Doctor

MANAGED CARE January 1999. ©1999 Stezzi Communications

Sutter Health, an integrated health system of 26 hospitals and 5,000 physicians in California, is using capitation to encourage greater cost-effective care. But it's not Sutter's primary care physicians who are being capitated.

When Sutter finishes work with its medical groups on a new payment scheme, primary care physicians will be paid on a fee-for-service basis, and specialists will be capitated. The idea is to cut the cost of specialist care while encouraging primary care physicians to provide more treatment without a referral. It has taken Sutter two years to put the plan together and win approval from its affiliated physicians.

The deal would seem to speak to a physician complaint noted in a New England Journal of Medicine article in November. Doctors lamented that financial incentives for speeding up office visits and limiting referrals compromise care, but said incentives based on patient satisfaction improve quality.

Meetings

Pharmaceutical Pricing and Contracting Conference Philadelphia, PA September 22–23, 2014
Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014