CAPITATION: Government Study Finds Patient Dissatisfaction
Saturday's New York Times reports that an unpublished government-funded study found higher levels of consumer dissatisfaction among patients whose primary care doctors are paid on a capitated basis. The study of 2,748 Massachusetts state employees was conducted at the New England Medical Center's Health Institute; it compared satisfaction levels of "patients whose primary doctors were paid on a per capita basis" with patients enrolled "in the same type of health maintenance organization whose doctors were reimbursed for the specific services they provided." Lead researcher Dana Gelb Safran said the study found that patients treated by doctors paid on a capitated basis "rated them lower on their level of concern, familiarity with individual problems and providing answers to all questions." However, the study found that "[o]ut-of-pocket costs were significantly lower for patients in the per capita group." And "[u]nder both payment systems, doctors rated about the same on referrals, thoroughness of exams and counseling on staying well." The Times article provides good overview of capitation and its growth. According to the American Medical Association, "the number of doctors with at least one capitation contract surged almost 50%, to 174,000, between 1994 and 1997." Currently, "[j]ust over one-third of the nation's 483,000 doctors ... have capitation contracts, although these represent only about one-fourth of their revenues" (Freudenheim, 5/30).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.