Physician's Capitation Trend-Capitation basics elude general public knowledge

Even though managed care pitfalls receive plenty of news coverage, many Americans have little notion of whether they have fee-for-service or managed care insurance, much less if they are in a capitation arrangement.

These and other findings released in a recent study suggest that policy-makers should take great care in making major health insurance decisions based largely on public opinion and/or self-reported surveys.

In a telephone survey of 351 randomly selected adults in Wisconsin, researchers found:

• 97% of those interviewed were able to identify if they had insurance, and most could name their primary care provider.

• 23.2% were incorrect in assuming they were covered by a family member.

• 33% correctly identified the length of time they had been covered by a specific plan.

• Individuals are often confused about what type of plan they have. In the survey, 84.2% of those in the survey who were covered by fee-for-service plans thought they were in HMO, or managed care plans.

Given the knowledge base of such complicated forms of insurance, Americans still need more education to understand terms such as capitation, preferred provider plan, point-of-service plan, and other terms health care experts tend to use, the authors recommended.

Reference

1. Nelson DE, Thompson BL, Davenport NJ, Penaloza LJ. What people really know about their health insurance: A comparison of information obtained from individuals and their insurers. Am J Public Health 2000; 90:924-928.