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Related Experiment Videos

Physician profiling and capitated income distribution

B F Overholt1

  • 1Gastrointestinal Associates, P.C., Knoxville, Tennessee, USA.

Gastroenterology Clinics of North America
|January 24, 1998
PubMed
Summary
This summary is machine-generated.

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Gastroenterologists can now easily create physician profiles for quality management and contracting. This method aids in fair capitation revenue distribution, rewarding cost-effective care and strong physician-patient relationships.

Area of Science:

  • Gastroenterology
  • Health Services Research
  • Healthcare Management

Background:

  • Physician profiling and capitation are increasingly important practice issues for gastroenterologists.
  • Effective quality management and contracting decisions require robust physician performance data.
  • Current methods for physician profiling and capitation revenue distribution may not adequately reward quality or cost-effectiveness.

Purpose of the Study:

  • To describe a straightforward method for generating practice-based physician profiles.
  • To present a methodology for distributing capitation revenue that incentivizes quality and cost-effective care.
  • To demonstrate a system that protects against both under- and over-utilization of services.

Main Methods:

  • Development of a practice-generated physician profiling system.

Related Experiment Videos

  • Implementation of a capitation revenue distribution model based on physician profiles.
  • Longitudinal use of the described methodology within the author's practice for over three years.

    • Main Results:

    • The described physician profiling method is easily implementable within a practice setting.
    • The capitation revenue distribution methodology successfully rewards cost-effective care delivery.
    • The system fosters desirable physician-patient relationships and prevents service under- or over-utilization.

    Conclusions:

    • Practice-generated physician profiles offer a practical tool for quality management and contracting.
    • The presented capitation revenue distribution model effectively aligns financial incentives with quality patient care.
    • This approach provides a sustainable model for gastroenterology practices navigating capitation and performance measurement.