Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

FTC, DOJ issue statements on clinical integration

    Capitation Management Report
    |April 2, 2004
    PubMed
    Summary
    This summary is machine-generated.

    Physician groups can use a roadmap to ensure clinical integration, avoiding antitrust issues when negotiating non-risk contracts. This guide helps participating physicians collectively bargain for better terms.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same journal

    Wellpoint, HealthNet and Prudential settle capitation lawsuit.

    Capitation management report·2006
    Same journal

    Medicaid programs turn to managed care and capitation to control costs.

    Capitation management report·2006
    Same journal

    HealthCare Partners works with hospitals to control utilization.

    Capitation management report·2006
    Same journal

    Advocate Health Care delivers quality under capitation.

    Capitation management report·2006
    Same journal

    Sharp uses integrated approach to stay profitably at-risk.

    Capitation management report·2006
    Same journal

    Physician use of EMRs varies depending on type of organization.

    Capitation management report·2006

    Area of Science:

    • Healthcare Economics
    • Antitrust Law
    • Physician Contracting

    Background:

    • Physician groups often face antitrust scrutiny when negotiating contracts.
    • Clinical integration is a key factor in determining the legality of collective physician negotiations.
    • Non-risk contracts are common arrangements between physicians and payers.

    Purpose of the Study:

    • To provide a roadmap for messenger-model Independent Practice Associations (IPAs) to assess their clinical integration.
    • To guide IPAs in avoiding antitrust challenges during collective negotiation of non-risk contracts.

    Main Methods:

    • The study outlines a framework for evaluating the degree of clinical integration within IPAs.
    • Key performance indicators and structural elements of integration are discussed.

    Related Experiment Videos

    Main Results:

    • Messenger-model IPAs can achieve sufficient clinical integration to legally negotiate non-risk contracts.
    • The roadmap provides actionable steps for IPAs to demonstrate integration and mitigate antitrust risks.

    Conclusions:

    • IPAs can successfully navigate antitrust regulations by focusing on clinical integration.
    • The proposed roadmap offers a practical approach for physician groups to engage in collective bargaining for non-risk contracts.