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Evaluating risk: global fees and episodic care.
Doug Emery1, Kurt Wrobel, Russell D Robbins
1Semmetry Health Data Systems, Inc., Phoenix, Arizona, USA. demery@adelphia.net
Physician Executive
|January 31, 2003
Summary
This study compares episode contracting to traditional capitation, finding episode contracting more attractive for physicians, payers, and patients. It highlights benefits of market-based healthcare models and direct contracting for integrated care.
Area of Science:
- Health Economics
- Healthcare Management
- Medical Policy
Background:
- Orthodox managed care models have inherent flaws.
- Previous research highlighted market-based models and direct contracting for integrated care.
Purpose of the Study:
- Compare episode contracting with traditional capitation.
- Outline advantages of episode contracting for stakeholders.
Main Methods:
- Comparative analysis of healthcare payment models.
- Review of features in episode contracting versus capitation.
Main Results:
- Episode contracting presents a more attractive alternative to capitation.
- Direct contracting for integrated episodes of care offers unique advantages.
Conclusions:
- Episode contracting systems are superior to traditional capitated programs.
- Market-based healthcare models benefit physicians, payers, and patients.