Résumé :
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[BDSP. Notice produite par INIST R0x0a608. Diffusion soumise à autorisation]. Context Independent practice associations (IPAs) are developing new methods of physician reimbursement to balance the objectives of encouraging individual productivity and clinical cooperation. The economic literature on payment incentives, derived from nonhealth industries, predicts that methods blending elements of fee-for-service and capitation will outperform exclusive reliance on either form of payment. Objective To identify emerging payment methods within IPA physician groups that contract with managed care organizations. Design and Setting Case studies of 7 large IPAs in the San Francisco, Calif, metropolitan region that served 826000 health maintenance organization (HMO) patients during the summer and fall of 1998. Main Outcome Measure Payment methods of IPAs for primary care physicians, specialists, and physicians grouped by specialty department within the overall IPA structure. Results All the IPAs contracted with multiple HMOs for the full range of primary and specialty care physicians'services but paid member physicians using methods that blended elements of fee-for-service and subcapitation. (...)
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