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Capitation in California—An Analysis of At-Risk Financing of Medicaid Services

机译：加州的人为负担-医疗补助服务风险融资分析

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Recent legislative changes have fostered the growth of a highly competitive health care market in California. In addition to selective hospital contracting for Medicaid (Medi-Cal) services, the California Medical Assistance Commission is attempting to initiate pilot projects to capitate Medi-Cal beneficiaries in selected geographic areas throughout the state. Selective contracting with county capitated organized health systems is also underway in Santa Barbara County, with plans for other counties on the drawing boards. This paper describes these capitated programs as well as addressing problems that may arise in this transition from a fee-for-service to a capitated Medi-Cal system. Specifically considered are issues related to underutilization, quality of care, implementation, eligibility and effects on existing patterns of care.

机译：最近的立法变化促进了加利福尼亚州竞争激烈的医疗保健市场的增长。除了有选择地签订医疗补助（Medi-Cal）服务的医院承包合同外，加利福尼亚州医疗救助委员会还试图启动试点项目，以使全州特定地理区域的Medi-Cal受益人屈服。在圣塔芭芭拉县（Santa Barbara County），也正在与有经验的有组织的卫生系统进行选择性签约，并计划在其他县制定计划。本文介绍了这些简化程序，并解决了从付费服务过渡到简化的Medi-Cal系统时可能出现的问题。特别考虑的是与利用不足，护理质量，实施，资格和对现有护理模式的影响有关的问题。

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期刊名称 California Medicine
作者
Neal Halfon; Paul W. Newacheck;
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年(卷),期 1986(145),2
年度 1986
页码 258–262
总页数 5
原文格式 PDF
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5. Access to health care: Medicaid fee-for-service versus capitation [D] . Gibson, P. Joseph 1996

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机译：获得医疗保健：医疗补助服务费与人头费。学位论文的执行摘要和最终报告

Capitation in California—An Analysis of At-Risk Financing of Medicaid Services

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