Document Detail


Variations in physician utilization patterns in a capitation payment IPA-HMO.
MedLine Citation:
PMID:  7144274     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Health care utilization data, using measures such as rates of hospitalization, physician visits, and specialty referrals, were collected for individual provider offices in an Individual Practice Association-Health Maintenance Organization (IPA-HMO) that used a capitation payment system to reimburse its primary physicians. Variations in health care utilization patterns between IPA offices were identified and examined for possible associations with other characteristics of these medical practices. As on indirect test of the effectiveness of the HMO's incentive system, it was hypothesized that IPA offices with a larger number of HMO subscriber-patients and those with a longer duration of membership in the IPA would exhibit practice patterns that would conform most with the HMO's cost control objectives. Associations were found between health care utilization measures and characteristics such as the specialty of physicians, but size of HMO patient load and length of IPA membership did not have the predicted effect. The findings of this study serve to identify several questions that need to be addressed in further assessments of the performance of IPAs that follow this general model.
Authors:
G L Burkett
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Medical care     Volume:  20     ISSN:  0025-7079     ISO Abbreviation:  Med Care     Publication Date:  1982 Nov 
Date Detail:
Created Date:  1983-01-07     Completed Date:  1983-01-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1128-39     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Capitation Fee*
Cost Control / trends
Evaluation Studies as Topic
Fees and Charges*
Fees, Medical*
Health Maintenance Organizations / utilization*
Humans
Medical Staff / economics*
Pennsylvania
Primary Health Care / economics
Reimbursement Mechanisms*
Reimbursement, Incentive*
Statistics as Topic
Grant Support
ID/Acronym/Agency:
1 RO3 HS 03485-01/HS/AHRQ HHS

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


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