Kaiser Permanente: integrating around a care delivery model

The risk-adjusted payment model mandated for Medicare + Choice organizations by the Balanced Budget Act of 1997 has significant implications for health care organizations that offer the Medicare + Choice program. Chronic medical conditions in the ambulatory care setting will become the focus of data capture, requiring significant retooling of ambulatory care operations. Health care organizations in California currently do not have the capital available to invest in the information management tools that will be required. Private practitioners continue not to have the technology and expertise to capture the data needed to run the model. Nevertheless, the risk-adjusted payment model presents the potential to better integrate care delivery around the continuum of health care needs of the population.