Jennings M C, Clark C S
Jennings Ryan and Kolb, Hadley, MA, USA.
Healthc Financ Manage. 1997 Dec;51(12):45-7.
A number of ideas regarding managed care and capitation are commonly accepted as truths. In reality, however, these ideas are half-truths or myths. Healthcare providers need to challenge some of these myths in order to respond proactively to change. Some of the traditional thinking about managed care that needs realignment includes the belief that PHOs essentially are transitional vehicles and not viable, long-term solutions; that the incentives under fee-for-service payment conflict totally with the incentives under capitation; that under global capitation, the best method for paying primary care physicians is capitation and the best way to pay specialists is discounted fee-for-service; and that small, exclusive physician panels are the most successful for managed care.
关于管理式医疗和按人头付费的一些观点通常被视为真理。然而,实际上这些观点只是半真半假或神话。医疗服务提供者需要挑战其中一些神话,以便积极应对变革。一些需要重新调整的关于管理式医疗的传统观念包括:认为初级保健组织本质上只是过渡性工具,而非可行的长期解决方案;认为按服务收费支付方式下的激励措施与按人头付费下的激励措施完全冲突;认为在全球按人头付费模式下,支付初级保健医生的最佳方法是按人头付费,支付专科医生的最佳方式是折扣后的按服务收费;以及认为小型、专属的医生团队对管理式医疗最为成功。