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The economic survival of pediatric practice
1White Memorial Medical Center, Los Angeles, USA.
Pediatrics
|October 1, 1995
Insights
Future pediatricians may be reimbursed through capitation, a payment model based on patient enrollment rather than services rendered. This analysis explores capitation
Area of Science:
- Healthcare economics
- Pediatric practice management
- Reimbursement models
Background:
- Future pediatric practice faces uncertainties, particularly regarding physician reimbursement.
- Current trends suggest capitation may become a dominant payment mechanism.
Purpose of the Study:
- To analyze the advantages and disadvantages of capitation compared to fee-for-service.
- To provide a simplified explanation of capitation rate setting.
Main Methods:
- Trend analysis of pediatric reimbursement over the past decade.
- Comparative discussion of capitation and fee-for-service models.
Main Results:
- Capitation is identified as a probable future reimbursement mechanism for pediatricians.
- Key benefits and drawbacks of capitation are outlined.
Conclusions:
- Understanding capitation is crucial for pediatricians navigating future practice environments.
- The study provides insights into the financial underpinnings of pediatric care delivery.
Abstract:
Many aspects of pediatric practice in the future are unclear. Among them is how pediatricians will be reimbursed. Based on trends established during the past 10 years, capitation is a likely mechanism. The advantages and disadvantages of capitation as a reimbursement mechanism--particularly as it compares with fee for service--are discussed, and a simplified description of how capitation rates are set is included.