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Related Experiment Videos

Does capitation matter? Impacts on access, use, and quality.

Samuel H Zuvekas1, Steven C Hill

  • 1Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA. szuvekas@ahrq.gov

Inquiry : a Journal of Medical Care Organization, Provision and Financing
|January 27, 2005
PubMed
Summary

Provider capitation in health maintenance organizations (HMOs) may improve access and preventive care but doesn't significantly impact quality. Group/staff HMOs show a stronger positive effect on care access and quality compared to capitation alone.

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Health Economics

Background:

  • Provider capitation is a payment model intended to control healthcare costs.
  • Concerns exist regarding potential negative impacts of capitation on access and quality of care.
  • Health maintenance organizations (HMOs) often utilize capitation models.

Purpose of the Study:

  • To examine the effects of provider capitation on the usual source of care for HMO enrollees.
  • To assess the influence of capitation on healthcare access and quality.
  • To compare the impact of capitation versus group/staff HMO organization on care delivery.

Main Methods:

  • Utilized generalized methods of moments (GMM) estimation to address endogeneity.
  • Analyzed data from the Medical Expenditure Panel Survey (MEPS) for 1996-1997.

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  • Focused on enrollees within health maintenance organizations (HMOs).

    • Main Results:

    • Group/staff HMO organization generally demonstrated a more significant impact on access and quality than capitation alone.
    • Capitation showed a potential to increase access to usual sources of care and improve primary preventive care.
    • However, the positive effects of capitation on access and preventive care were not statistically significant when using GMM estimation.
    • Coordination of care did not appear to be improved by capitation.

    Conclusions:

    • Organizational structure (group/staff HMO) may be a more influential factor in healthcare access and quality than provider capitation.
    • While theoretically beneficial, the empirical evidence for capitation's positive impact on access and preventive care in this study was not statistically robust.
    • Further research may be needed to fully understand the nuanced effects of capitation in different healthcare settings.