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Getting ready for professional-risk capitation
1College of Professional Studies, University of San Francisco, CA 94117, USA.
Medical Group Management Journal
|October 4, 1997
Summary
Physician groups should prepare for managed care by building diverse, credentialed networks. Advance planning for capitation compensation is crucial for attracting health plans.
Area of Science:
- Health Services Research
- Healthcare Management
- Physician Network Development
Background:
- California's healthcare landscape often foreshadows national trends.
- The rise of managed care plans presents both opportunities and challenges for physician groups.
Purpose of the Study:
- To advise physician group managers on proactive strategies for managed care.
- To highlight the importance of network diversity and credentialing for attracting managed care contracts.
- To emphasize the need for strategic planning regarding capitation compensation models.
Main Methods:
- Analysis of healthcare trends in California.
- Expert recommendations for physician group management.
- Forecasting the impact of managed care on physician networks.
Main Results:
- Physician groups must develop geographically diverse and credentialed networks.
- Managed care plans are increasingly seeking robust physician networks.
- Capitation models require careful financial and operational planning.
Conclusions:
- Proactive network development is essential for physician groups to thrive in a managed care environment.
- Strategic planning for compensation, particularly under capitation, is vital for securing managed care contracts.
- Adapting to the evolving healthcare market, as exemplified by California, is key to long-term success.