My advice is that physicians adopt new approaches that will allow them to exploit capitation and become more attractive to health plans. Many physicians are quite skilled in the conservative treatment of patients. It's valuable, and when it is encouraged under a risk contract, there may be new money in the system for the physician. Accepting capitation payment, which factors in all those traditional costs, becomes an opportunity for physicians to participate in the savings their case management brings. If they leave our practice thinking that's what they got, we won't last long on the plan.
Patients are more demanding than ever before.
Many know at least a bit about managed care and are on guard against being shortchanged. So the practices that treat managed care patients like second-class citizens run the risk of generating complaints that will go back to the employers who pay the bills and the managed care organizations that contract for the care. When you have the best doctors and the best staff and give the best care, you're likely to attract more than your fair share of capitation enrollments. And you're more likely to negotiate a higher capitation premium if the plan sees your service as essential to its continued success. If you're ordinary, expect to be treated as a replaceable resource and priced accordingly.