Bringing managed care incentives to Medicare's fee-for-service sector.
Tompkins, Christopher P
Date of Pub
Bhalotra, Sarita; Chilingerian, Jon A; Glavin, Mitchell P; Hodgkin, Dominic; Ritter, Grant A; Wallack, Stanley S
The Health Care Financing Administration (HCFA) could work with eligible physician organizations to generate savings in total
reimbursements for their Medicare patients. Medicare would continue to reimburse all providers according to standard payment
policies and mechanisms, and beneficiaries would retain the freedom to choose providers. However, implementation of new financial
incentives, based on meeting targets called Group-Specific Volume Performance Standards (GVPS), would encourage cost-effective
service delivery patterns. HCFA could use new and existing data systems to monitor access, utilization patterns, cost outcomes
and quality of care. In short, HCFA could manage providers, who, in turn, would manage their patients' care.
Reimbursement, Incentive : Relative Value Scales : Capitation Fee : Cost Control : Fee-for-Service Plans/economics/utilization
: Health Expenditures : Managed Care Programs/economics/utilization : Medicare Part B/economics/organization & administration
: Support, U.S. Gov't, Non-P.H.S. : United States : United States Health Care Financing Administration : Utilization Review