Most institutions within PennCARE actually have some employed physicians. That's not to say that those physicians can't and wouldn't be eager to receive a series of services that would frankly enable them again to take better care of their patients. Describe your recently signed ten-year contract with US Healthcare. It's a full risk arrangement where PennCARE is responsible for all of the care consumed by a population of patients. Physicians in PennCARE do not have to only refer US Healthcare patients within the PennCARE system.
Individual physicians have a choice.
They can participate with US Healthcare through PennCARE or they can choose not to participate with US Healthcare at all. Primary care physicians in PennCARE who choose to sign up actually get better capitation rates for caring for patients through US Healthcare than they would get caring for those patients through US Healthcare alone. There's the opportunity of a surplus or a deficit when all the accounting is done at the end. That amount can be reinvested in hospitals that are not for-profit organizations and in their communities, their medical staff and physicians to improve their compensation and to take better care of their patients. The case mix index, an important measure of severity, for Lehigh Valley Hospital is the same as almost all the teaching hospitals in Philadelphia.