Physician's Capitation Trends
Public perception pans capitated health care
While employers are biting the bullet to pay for health care, employees are complaining about the quality of the health care they’re getting — even if they aren’t actually in capitated arrangements. The result is leaving insurers with a negative stereotype overall of insurance, according to James D. Reschovsky, senior researcher and co-author of an attitudinal study of health coverage conducted by the Center for Studying Health System Change in Washington, DC.1
"These results strongly imply that negative perceptions about HMOs adversely color how consumers rate their own health care and health providers," Reschovsky says. In the survey of 18,000 households, 13% of people in HMOs thought they were not in HMOs, and 11% of those in HMOs thought they were in other kinds of plans. Taken together, it suggests that 24% of people who register an opinion about their health care plan structure are incorrect about the type of structure they’re in. "Instead of poll results reflecting people’s experience in using health care, it seems as if people’s beliefs about plan type, driven in part by polls and media coverage, are driving survey results," he says.
In the "first wave" of capitation frenzy in the early 1990s, when capitation’s successes were heralded, many experts said "easy savings" were achieved because of financial excesses inherent in fee-for-service payment structures. Capitation was effective at reducing those excesses. Once those savings were realized, however, the hard work began to make capitation workable for everyone involved. In some cases, the public felt it only worked if services were unduly cut back. Now, insurers and providers are working at finding ways to meet each other half way in terms of lowering costs as well as encouraging healthier patient behaviors.
"The study [of public attitude toward HMOs] does not in itself argue for or against efforts to further regulate HMOs," says Paul Ginsburg, MD, president of the center. "But it does underscore the need for clinical data to better understand how HMOs stack up to other kinds of plans."
Reference
- Center for Studying Health System Change. Health Care Perceptions and Experiences: It’s Not Whether You Are in an HMO, It’s Whether You Think You Are. Washington, DC; 2000.
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