Specialty capitation and effectiveness assessment

In 1988, the Southern Region of Blue Cross Blue Shield of Florida undertook a major initiative involving Health Options, Inc., its HMO subsidiary. The intent was to convert specialty contracting from a discounted fee-for-service methodology to capitated payment. Each specialty network is radically transformed into a freestanding IPA, independently incorporated and contracted to the plan for the provision of all included services. The project has financial and legal implications, and maintenance of quality and member satisfaction has been a paramount consideration.