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Evaluating risk: global fees and episodic care
Authors:Emery Doug  Wrobel Kurt  Robbins Russell D  Tully Lorraine  Schulte Lisa
Affiliation:Semmetry Health Data Systems, Inc., Phoenix, Arizona, USA. demery@adelphia.net
Abstract:
In 1999, two articles in The Physician Executive -- "Part I: Global Theory and the Nature of Risk (July-August)." and "Part II: Towards a Choice-Based Model of Managed Care (October-November)" -- outlined the flaws of orthodox managed care theory and highlighted the unique advantages of moving to a genuinely market-based model, which included the concept of direct contracting for integrated episodes of care. This follow-up focuses on comparing an episode contracting system to a traditional capitated program and outlines the features that make this approach much more attractive to physicians, payers, and most importantly patients.
Keywords:
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