Document 0174
 DOCN  M9550174
 TI    The impact of physician financial incentives on high-risk populations in
       managed care.
 DT    9505
 AU    Hillman AL; Center for Health Policy, Leonard Davis Institute of Health;
       Economics, University of Pennsylvania, Philadelphia 19104.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8 Suppl 1:S23-30.
       Unique Identifier : AIDSLINE MED/95136008
 AB    The challenge of managed care is to design a system in which rules and
       incentives together create a system of checks and balances that ensure
       both efficient and high-quality care. Incentives need to be administered
       so that physicians--both primary care providers and specialists--are not
       forced to choose between personal and/or organizational financial
       viability and patients' care. To accomplish this goal, payment needs to
       be linked both to quality and productivity and appropriately
       risk-adjusted. Quality assurance programs must ensure that both
       efficient and high-quality care is being provided and must maintain the
       satisfaction of both physicians and members. AIDS patients may be harmed
       by a system in which the more services a physician performs, the more he
       or she is paid--the traditional way in which American health care has
       been delivered heretofore. Managed care may undermine the care of
       high-risk patients if it arbitrarily reduces the high volume of care
       they require. However, a managed care system with effective checks and
       balances on financial incentives and quality of care can ensure that an
       efficient and high standard of care is being met--across all
       populations, including both healthy and high-risk patients.
 DE    Acquired Immunodeficiency Syndrome/*ECONOMICS/THERAPY  Comparative Study
       Diagnosis-Related Groups  Evaluation Studies  Health Status Indicators
       Human  Managed Care Programs/*ECONOMICS/TRENDS  Physician Incentive
       Plans/*ECONOMICS/TRENDS  Prospective Payment System  Quality of Health
       Care  Reimbursement Mechanisms  United States  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).