RESUMEN
Horror stories abound about providers that have failed to modify their incentive systems and have exhausted their annual capitation budget in the first six months of the plan year. Aligning the business strategy and financial incentives in advance is the best way to ensure that your integrated delivery system's transition to capitation is a success story. Rarely are physicians or hospitals with experience limited to the fee-for-service arena prepared to jump into a managed care or capitated compensation system. The transition can be eased by implementing a "shadow" capitation or similar arrangement that will test physician performance under a risk arrangement in advance. The information can be used to restructure the compensation system to ensure that the behaviors being encouraged will promote successful care and fiscal management.
Asunto(s)
Redes Comunitarias/economía , Programas Controlados de Atención en Salud , Planes de Incentivos para los Médicos/economía , Capitación , Control de Costos , Programas Controlados de Atención en Salud/economía , Auto Remisión del Médico/legislación & jurisprudencia , Pautas de la Práctica en Medicina/economía , Salarios y Beneficios , Exención de Impuesto , Estados Unidos , Recursos HumanosRESUMEN
In response to the changing healthcare market, many providers are forming networks for managed care contracting. These networks may fail, however, if planning focuses on maintaining business practices of the past rather than responding to market forces of the future. Effective planning for managed care requires that network executives establish a vision of the future that is not shackled by experiences of the past, articulate a mission that outlines what the network's role will be in the future, and create strategies that will help the network fulfill its mission. Although financial data are necessary to measure a network's progress toward fulfilling its mission, data on past performance should not be used to shape a vision of the future.
Asunto(s)
Redes Comunitarias/economía , Eficiencia Organizacional/normas , Administración Financiera de Hospitales/métodos , Programas Controlados de Atención en Salud/organización & administración , Administración Financiera de Hospitales/tendencias , Programas Controlados de Atención en Salud/economía , Programas Controlados de Atención en Salud/tendencias , Comercialización de los Servicios de Salud , Objetivos Organizacionales , Técnicas de Planificación , Estados UnidosRESUMEN
Surgery asks patients to trade present discomfort and risk for future gains. Although research reports on the effectiveness of surgery have largely focused on mortality, length of hospital stay, major complications, and laboratory analyses, the principal criteria guiding surgeons' clinical decisions and patients' acceptance of treatment are most often the patients' subjective feelings and capabilities, the quality of their lives. This is true for both major and minor surgical procedures. We discuss the role of information on functional capacity, overall well-being, and quality of life in the assessment of surgical outcomes. Broadening the choice of endpoints beyond traditional, so-called "hard" variables in surgical studies has advantages for both surgeons and patients.