Barth S M
Independence Blue Cross Family of Companies, Philadelphia, PA, USA.
Manag Care Q. 1997 Winter;5(1):19-24.
Capitation payment mechanisms promote conservative use of medical resources by transferring risk to the decision maker, the physician. However, there is another view of capitation: defining common risk between provider-driven organizations (i.e., physician/hospital organizations (PHOs) or integrated delivery systems (IDS), and risk-managing entities such as HMOs or insurance companies. This article discusses a strategy to align provider and risk manager incentives to share the risks and rewards for a total book of business or population.
按人头付费机制通过将风险转移给决策者（即医生）来促进医疗资源的保守使用。然而，对于按人头付费还有另一种观点：界定由提供者驱动的组织（即医师/医院组织（PHOs）或综合服务体系（IDS））与诸如健康维护组织（HMOs）或保险公司等风险管理实体之间的共同风险。本文讨论了一种策略，以使提供者和风险管理者的激励措施保持一致，从而就全部业务量或全体人群来分担风险与回报。
