‘Delegated Model’ of Health Care Effective, But Needs Improvement, Study Finds
The "delegated model" of health care in California has successfully lowered costs and improved quality of care, a new report from the Integrated Healthcare Association finds. Under the delegated model, physician groups are responsible for managing the care of patients enrolled in HMOs, taking on the risk of losing money if care costs exceed payments from HMOs. Although this model has become the "preferred system" in California, the study found it "is at a critical juncture and needs to evolve." In addition to cutting costs and improving quality, the delegated model of health care has improved the "financial situation" for physician groups, the report found. However, the report also found that the relationship between health plans and physician groups "remains poor," and "consolidation" of the doctor groups needs to occur. Beau Carter, executive director of the IHA, said, "We simply have too many physician groups taking risk. Additional consolidation needs to occur, and the challenge to all parties is to ensure that patients do not suffer in a transition, physician groups do not try to grow too quickly, and health plans reward better performing groups with both enrollment growth and performance-based payments." The study, called "Delivering Managed Care Through Physician Groups: The California 'Delegated Model' is Working But Needs To Evolve," is an update of a similar study released in 1999 (IHA release, 6/19).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.