Douglas Carnall wrote:
At Thu, 23 Jan 2003 09:28:04 -0500 [EMAIL PROTECTED] wrote:
Let's say that MetroHealth system works on a 60% fee for service/ 40%
capitation model for physician re-imbursement.
Let's further suppose that downward price pressure (can anyone say
Medicare/Medicaid cuts?) is reducing fee for service aggregate revenue.
Then, as a physician, the economic incentive is to see more patients and
that might mean spending less time/patient doing data input.
The other element of physician income that drives computerisation here in
the UK is target payments for achievement in the practice population for
things like immunisations, cervical screening, ischaemic heart disease
secondary prevention etc. Very difficult to achieve without computerisation.
That's a capability that the payor's can do. If there is only one and
they are concerned with health outcomes and not competition, they can
re-allocate financial incentives like this. It's fairly difficult to do
in a purely competitive payor market with your customers making purchase
decisons on a yearly basis based on your costs! A large and informed
customer (say an IBM or GM or FORD or a Government) could offer to pay
for extra services rendered at point of care realizing they won't get
the gains back for several years and then probably not at the same point
of care, they could negotiate a multi-year deal with the payor
organization, in co-operation with a provider organization to achieve that.
