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Related Experiment Videos

A view from under the microscope. Medicare prospective risk contracting.

G R Nycz, F J Wenzel

    Medical Group Management
    |April 11, 1983
    PubMed
    Summary

    Marshfield Clinic

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    Area of Science:

    • Healthcare Management
    • Health Policy
    • Medicare Contracting

    Background:

    • Overview of a four-year demonstration contract between Marshfield Clinic and HCFA.
    • Enrollment of over 8,900 Medicare beneficiaries under a prospective risk contract.

    Purpose of the Study:

    • To provide an overview of the demonstration contract.
    • Discuss public policy implications and recommendations for group practices.
    • Highlight potential challenges in Medicare prospective contracting.

    Main Methods:

    • Analysis of a four-year demonstration contract data.
    • Review of enrollment numbers and contract outcomes.
    • Identification of key considerations for prospective risk contracts.

    Main Results:

    • Successful enrollment of 8,900+ Medicare beneficiaries.
    • Identification of critical factors for prospective contracting success.
    • Data valuable for other organizations considering similar contracts.

    Conclusions:

    • Prepaid Medicare, with refinements, can benefit beneficiaries and providers.
    • Attention to adverse selection and utilization control is crucial.
    • Methodological challenges in prospective reimbursement require careful management.

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