Med Netw Strategy Rep. 1999 Mar;8(3):1-8.
Single-specialty carve-out contracts under capitation are booming nationwide, fueled by economic and practice management incentives. What isn't clear yet is how these arrangements between health plans and physicians will affect integrated health systems, multispecialty group practice-based medical management, and the roles and referral patterns of primary care physicians. For many primary care physicians and multispecialty group leaders, carve-outs represent an economically driven challenge to good medical management. But health plans, and many specialists, argue that carve-outs help patients/plan members, physicians, and the care management process. One's viewpoint on the issue seems to depend largely on the health system interests one has at stake.
在经济和实践管理激励措施的推动下,按人头付费的单一专科分离合同在全国范围内蓬勃发展。目前尚不清楚的是,健康计划与医生之间的这些安排将如何影响综合医疗系统、基于多专科团体执业的医疗管理,以及初级保健医生的角色和转诊模式。对于许多初级保健医生和多专科团体负责人来说,分离合同对良好的医疗管理构成了经济驱动的挑战。但健康计划以及许多专科医生认为,分离合同有助于患者/计划成员、医生以及护理管理流程。人们对这个问题的看法似乎很大程度上取决于自身所涉及的医疗系统利益。