From capitation to fee-for-service in cincinnati: a physician group responds to a changing marketplace.

The experience of Group Health Associates, a multispecialty practice physician group in Cincinnati, Ohio, offers an important case study of how payment incentives and market realities can change the way physicians practice medicine. After nearly thirty years as a capitation-based medical group, these physicians recently switched completely to fee-for-service reimbursement-not willingly, but in response to an evolving marketplace. Their new business strategy seeks to create a case for being paid for performance and treating the chronically ill.