Kazahaya G I
Healthc Financ Manage. 1986 Aug;40(8):70-3.
Hospitals are encountering a new type of HMO--the risk-based, risk-sharing capitated HMO. This new HMO arrangement redefines the role of the hospital, the physicians, and the HMO plan involved. Instead of placing the HMO at risk, the hospital and physicians are now financially responsible for services covered under the HMO plan. The capitated HMO is reduced to a third-party payer, serving as a broker between subscribers and providers. In this first of two articles on capitated HMOs, the risk-based, risk-sharing capitated HMO and its relationship to hospitals and physicians is defined. The second article will take this definition and apply it to managing, monitoring, and reporting on these types of programs from an accounting perspective.
医院正在遭遇一种新型的健康维护组织（HMO）——基于风险、共担风险的按人头付费健康维护组织。这种新的健康维护组织安排重新定义了医院、医生以及相关健康维护组织计划所扮演的角色。如今，并非让健康维护组织承担风险，而是医院和医生要对健康维护组织计划涵盖的服务承担财务责任。按人头付费的健康维护组织沦为第三方支付方，充当订阅者与提供者之间的经纪人。在关于按人头付费健康维护组织的这两篇文章的第一篇中，定义了基于风险、共担风险的按人头付费健康维护组织及其与医院和医生的关系。第二篇文章将采用这一定义，并从会计角度将其应用于这些类型项目的管理、监督和报告。
