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Related Experiment Videos

Does a year make a difference? Changes in physician satisfaction and perception in an increasingly capitated

E S Nadler1, S Sims, P H Tyrance

  • 1Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.

The American Journal of Medicine
|July 14, 1999
PubMed
Summary

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Physician satisfaction with capitation improved after one year, but concerns about this payment model persisted. Experience with capitation did not fully alleviate physician apprehension regarding its differences from fee-for-service.

Area of Science:

  • Health Services Research
  • Medical Economics
  • Physician Payment Models

Background:

  • Capitation is a growing healthcare payment model.
  • Limited data exists on physician satisfaction with increasing experience in capitation.

Purpose of the Study:

  • To assess changes in physician satisfaction with capitation over time.
  • To compare physician satisfaction between capitated and fee-for-service models.
  • To evaluate ethical concerns associated with capitation.

Main Methods:

  • Surveyed physicians in an urban teaching hospital's physician-hospital organization in 1996 and 1997.
  • Assessed changes in practice satisfaction, comparing fee-for-service and capitation.
  • Monitored the increase in capitated contract coverage from <5% to nearly 25% for patients under 65.

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Main Results:

  • Overall physician satisfaction increased from 57% in 1996 to 71% in 1997.
  • Physicians reporting increased satisfaction with patient load, discussion time, and care coordination.
  • Despite improvements, physicians remained significantly more satisfied with fee-for-service than capitation in both years.

Conclusions:

  • Initial physician perceptions of capitation were negative.
  • Physician satisfaction with capitation improved with experience, but dissatisfaction compared to fee-for-service widened.
  • Physician concerns regarding capitation may not be resolved solely through experience.