Capitation and its effects on physician satisfaction.

Area of Science:

• Health Services Research
• Medical Economics
• Physician Workforce Studies

Background:

• Capitation payment is increasingly prevalent in healthcare reimbursement.
• Limited data exists on the impact of capitation on physician satisfaction.
• Academic medical centers are adopting capitation models, necessitating an understanding of physician perspectives.

Purpose of the Study:

• To examine the perceived effects of capitation on physician satisfaction.
• To compare physician satisfaction under fee-for-service versus capitation models.
• To identify factors influencing physician satisfaction in a capitated environment.

Main Methods:

• A survey was conducted among physicians at a large, urban, tertiary care teaching hospital.
• A 5-point Likert scale assessed satisfaction with current practice and expected satisfaction under capitation.
• Logistic regression analysis identified predictors of overall physician satisfaction.

Main Results:

• A 62% response rate (363/587) was achieved among physicians with direct patient care responsibilities.
• Physicians reported significantly lower satisfaction with caring for capitated patients compared to fee-for-service.
• Key factors influencing overall satisfaction included patient load, resource utilization efficiency, employment stability, and schedule control.

Conclusions:

• Physicians initially exposed to capitation exhibit strong negative perceptions, even in areas where benefits are anticipated.
• Physician education and enhanced management relations are recommended to facilitate the transition to capitated reimbursement.
• Addressing physician concerns is vital for successful implementation of capitation models.