Capitation pros and cons

[Caesarsgrl]

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I've only recently discovered what this is and was hoping that someone might be bale to explain some of the pros and cons of the issue

Thanks 🙂

 

[constructor]

I've only recently discovered what this is and was hoping that someone might be bale to explain some of the pros and cons of the issue

Thanks 🙂

it's the system whereby doctors get paid at a rate that corresponds to the number of patients subscribing to that doctor's services in a (usually) HMO plan. it involves more risk for the doctor because they are paid a fixed rate per patient and it is possible that in a given year there are many patients requiring expensive procedures or diagnoses, so the doctor can end up essentially providing more services than he has been paid for. in a traditional plan that doesn't try to save cost using managed care, doctors get a specific amount for each service they perform from the combination of the patient and his or her insurance. fee-for-service doctors tend to make more money and also make unnecessary use of expensive diagnostic tools and surgeries because they get money for doing so, whereas in a capitation setup there is a great incentive for withholding expensive care when it is not totally warranted (which can also be bad i guess). the hmo also rewards doctors financially (and with stock options) if they spend below their capitation rate for a given year.

 

[Medikit]

Con: If you undo it then someones head falls off.

 

[nockamura]

Haha medikit. That's exactly what I was thinking/

 

[nasdr]

if you get a question on capitation/HMOs/managed care, try to show both sides of the issue. There were a few good things that came from managed care, including cost control via primary care physician as gatekeeper as well as implementation of quality assessment standards. I got this question at an interview, and the doc said she liked the balanced response.

 

[beastmaster]

if you get a question on capitation/HMOs/managed care, try to show both sides of the issue. There were a few good things that came from managed care, including cost control via primary care physician as gatekeeper as well as implementation of quality assessment standards. I got this question at an interview, and the doc said she liked the balanced response.

Rubbish. Stick to a hard-line, extreme position and argue it fervently. Don't give an inch !!

 

[Haybrant]

Rubbish. Stick to a hard-line, extreme position and argue it fervently. Don't give an inch !!

yah, and dont get into med school; chances are one will not know enough about policy to argue one side only. Reading a bit online prior to an interview is not enough to take a hardline stance...

 

[ny skindoc]

An advantage of capitation is that physicians receive a fixed amount of money from the insurance company at regular intervals.That allows them to plan their office management knowing they will be recieving a guaranteed income.Some physicians like that but most practitioners feel capitation does not adequately compensate them for difficult or complicated patients who may need or demand more that average attention.Most docs like knowing they are getting paid per visit/procedure.