Scale and structure of capitated physician organizations in California.

Reevaluation of capitation contracting in New York and California.

We obtained detailed quantitative and interview data from Aetna U.S. Healthcare and six physician organizations to examine changes between 1998 and 2000 in the scope of capitation contracting and delegation of responsibility for claims payment and medical management in New York and California. The physician organizations in New York included Benchmark (Continuum), Montefiore IPA, and Lenox Hill...

Medical groups in California: managing care under capitation.

California-based health maintenance organizations (HMOs) have reduced use of hospital services well below national averages; much of this reduction appears linked to lower surgical procedure rates. Also, multispecialty groups in California have been able to maintain physician compensation under capitated payment arrangements at the expense of retaining earnings at the group level. With capitati...

State regulation of capitated reimbursement for physician-hospital organizations.

Competition through physician-managed care: the case for capitated multispecialty group practices.

The dominant managed care model in the USA is the individual practice association (IPA), in which physicians in separate practices contract with a health plan. One alternative model, the capitated multispecialty group practice (CMGP), has some distinct advantages: (i) the best randomized trial comparing a health management organization (HMO) with indemnity insurance showed equivalent health out...

Organizational systems used by California capitated medical groups and independent practice associations to increase cancer screening.

BACKGROUND Patients in health maintenance organizations (HMOs) appear to have higher utilization of cancer screening tests than patients with fee-for-service insurance. METHODS The authors surveyed the medical directors of 174 physician organizations in a California network model HMO to obtain information regarding their organizational structure, implementation of guidelines, and use of syste...