Document Detail


Reevaluation of capitation contracting in New York and California.
MedLine Citation:
PMID:  11911321     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We obtained detailed quantitative and interview data from Aetna U.S. Healthcare and six physician organizations to examine changes between 1998 and 2000 in the scope of capitation contracting and delegation of responsibility for claims payment and medical management in New York and California. The physician organizations in New York included Benchmark (Continuum), Montefiore IPA, and Lenox Hill Healthcare Network. In California they included Brown and Toland Medical Group, Monarch Healthcare, and Santa Clara County IPA. In both California, where global and shared risk capitation have been common, and New York, where they have not, we find movement to reduce the scope of prepayment and a rethinking of the delegated contractual relationship by physician organizations and health plans. This represents a departure from the 1990s, when many industry participants and analysts expected capitated and delegated relationships to spread across the nation.
Authors:
James C Robinson; Lawrence P Casalino
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Health affairs (Project Hope)     Volume:  Suppl Web Exclusives     ISSN:  0278-2715     ISO Abbreviation:  Health Aff (Millwood)     Publication Date:  2001  
Date Detail:
Created Date:  2002-03-25     Completed Date:  2002-04-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8303128     Medline TA:  Health Aff (Millwood)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  W11-9     Citation Subset:  IM    
Affiliation:
University of California, Berkeley, USA. jamie@socrates.berkeley.edu
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MeSH Terms
Descriptor/Qualifier:
Benchmarking
California
Capitation Fee / statistics & numerical data,  trends*
Contract Services / economics,  statistics & numerical data,  trends
Health Maintenance Organizations / economics,  statistics & numerical data*,  trends,  utilization
Hospital-Physician Joint Ventures / economics,  statistics & numerical data*,  trends,  utilization
Independent Practice Associations / economics,  statistics & numerical data*,  trends,  utilization
Insurance, Health, Reimbursement
Medicare / organization & administration,  statistics & numerical data
New York
Organizational Case Studies
Practice Management, Medical / economics*,  statistics & numerical data
Preferred Provider Organizations / economics,  statistics & numerical data*,  trends,  utilization

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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