Summary
Regrettably, many physicians feel that dealing with dollars is less then fulfilling, especially in light of off-loading potential costs of defensive medicine. The very turbulent times ahead will give employed groups of physicians a strategic advantage over individually fragmented doctors attempting to win managed care contracts. Certainly, CMS will look to contract blocks of medicare (and medicaid) live with better organized hospital and physician entities capable of making a group decision to accept or reject a contract. The game remains about lowering fixed costs. The industrialization of medicine is here to stay.Paradoxically, it remains their best chance at maintaining professional and financial autonomy. The capitated contract is tried and true, and does keep healthcare inflation down better then anything else we have tried over the last 20 years.
Analysis
How you pay doctors (the ones that order procedures) does affect how they practice. Doctors do have a tool to eliminate truly unpredictable health care cost risk. It is Provider Stop Loss, a coverage that pays claims over $10,000 - $1,000,000.There are many risk assuming entities that doctors have choice of forming to accept managed care contracts. Groups that are able to effectively lead their physician constituency will win more contracts. So far, employed physicians networked within hospital networks are the game to beat.
