As the health care market evolves, physicians will be wise to adopt new ways of dealing with managed care organizations, says this consultant, especially when it comes time to ink capitation contracts. By Jeffrey J. Denning Contributing Editor Managed care organizations are now part of the fabric of every metropolitan area and many less populous areas. No matter where doctors reside, I hear them wrestling with concepts and practices such as capitation, utilization review and credentialing. 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.