In the shoulder girdle group, duration of complaints was significantly shorter after manipulation compared with physiotherapy. Manipulation was superior to physiotherapy after five week. The results of our study suggest that manipulation is to be preferred to physiotherapy for treating shoulder complaints originating from the shoulder girdle in general practice. The dramatic turnaround comes at a time when HMOs across the state are losing money hand over fist. More than half of the state's 39 HMOs ended their last fiscal year in the red.
Capitation is also on the way out, the article notes.
Seems open access and capitation are incompatible with each other. Open access plans are a sign of the death of the gatekeeper concept. We're still focusing on controlling costs, but on high cost items like inpatient admissions, instead of requiring referral on all categories through a primary care doctor. Watch this scenario, it will repeat, it will be presented with different labels but it will be a simple recycling process. PacifiCare is the fifth largest provider of group health plans in the country.