On the other hand, in mature markets hospitals and physicians can target areas where they can gain new leverage. For example, if capitation has been initiated for a specialty service, the payers and providers may decide to develop global price packages for some high-cost services within the capitation. This strategy aligns all physician and hospital services with the same incentives. For example, in neurosurgery, craniotomy procedures can be very expensive. Developing global packages for these services makes sense because it increases the incentives for cost efficiency, and services such as radiology, pathology, and anesthesiology can be included in the package.
Many payers are interested in global or capitated arrangements with physicians and hospitals.
A proactive approach to managed care allows hospitals and physicians to move into new arrangements to test payment structures. Whenever possible, providers want the hospital and physicians to be included in these arrangements together. This provides the opportunity to develop models of risk-sharing that result in incentives to decrease utilization and costs. The high cost of specialty care encourages payers to create special arrangements. Develop products to meet market demand.