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The Physician Market Part 2

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The Physician Market, Part 2 Professor Vivian Ho Health Economics Fall 2007 These slides draw from material in Santerre & Neun, Health Economics, Theories, Insights and Industry Studies, Thomson Press 2007
Advantages of capitation for physicians ,[object Object],[object Object],[object Object],[object Object],[object Object]
MCOs and Physician Conduct ,[object Object],[object Object],[object Object]
Types of Managed Care Orgs
MCOs and Physician Conduct ,[object Object],[object Object],[object Object],[object Object],[object Object]
MCOs and Physician Conduct ,[object Object],[object Object],[object Object]
Financial Risk Arrayed on a Spectrum from Full Risk for the Insurer to Full Risk for the Provider HBS Case Study 9-698-060, Note on Managed Care
Additional MCO Compensation Tools ,[object Object],[object Object],[object Object],[object Object]
Additional MCO Compensation Tools ,[object Object],[object Object]
Additional MCO Compensation Tools ,[object Object],[object Object],[object Object],[object Object],[object Object]
Additional MCO Compensation Tools ,[object Object],[object Object],[object Object]
HMO Reimbursement Strategies ,[object Object],[object Object],[object Object]
Additional MCO Compensation Tools ,[object Object],[object Object]
 
Advantages of capitation for physicians ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
4 Components of a Capitated Contract 1) Covered Services Definitions such as “primary care services within the physician’s scope of practice” are too vague Examples of capitated primary services:
Examples of Current Procedure Terminology ,[object Object],[object Object],[object Object],[object Object]
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[object Object],[object Object],[object Object]
 
 
 
 
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evidence on Physicians & MCO Compensation ,[object Object],[object Object]
Evidence on Physicians & MCO Compensation ,[object Object],[object Object],[object Object],[object Object]
Physician Market Performance ,[object Object]
Physician Market Performance Revenue per Self-Employed Physician, ($1,000s) Increases in revenues are due to increases in expenses AND higher income for physicians
Physician salaries remain high ,[object Object],[object Object],[object Object]
Employed vs. Independent Physicians ,[object Object],[object Object],[object Object],[object Object]
Physician Practice Management (PPMs) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fortune Magazine, March 3, 1997
[object Object],[object Object],[object Object]
[object Object],[object Object]
What Went Wrong ,[object Object],[object Object],[object Object],[object Object]
What Went Wrong ,[object Object],[object Object],[object Object],[object Object]
MedPartners’ Reaction ,[object Object]
The Future of PPMs ,[object Object],[object Object],[object Object]

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The Physician Market Part 2

  • 1. The Physician Market, Part 2 Professor Vivian Ho Health Economics Fall 2007 These slides draw from material in Santerre & Neun, Health Economics, Theories, Insights and Industry Studies, Thomson Press 2007
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  • 4. Types of Managed Care Orgs
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  • 7. Financial Risk Arrayed on a Spectrum from Full Risk for the Insurer to Full Risk for the Provider HBS Case Study 9-698-060, Note on Managed Care
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  • 16. 4 Components of a Capitated Contract 1) Covered Services Definitions such as “primary care services within the physician’s scope of practice” are too vague Examples of capitated primary services:
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  • 30. Physician Market Performance Revenue per Self-Employed Physician, ($1,000s) Increases in revenues are due to increases in expenses AND higher income for physicians
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