Capitation Budgeting and the 13 Gateway to Care Sites (An Aggregate Look)

摘要

This study details the behavioral changes noted in the Army Medical Department's(AMEDD) Gateway To Care (GTC) sites in response to capitation budgeting. Average Length of Stay, Case Mix Index, and the number of Outpatient Visits are examined in this study to determine what influences capitation has on these three variables. Results of the study indicate that Average Length of Stay has decreased, while Case Mix Index and number of Outpatient Visits have increased. This outcome is consistent with the trends resulting from the Prospective Payment System of Medicare, and trends of managed care in general. The Conclusions drawn in this study will serve as a catalyst to support seeking 'at risk' capitation budgeting methodology in the DOD Tri-care contracts being let throughout the Tri-care regions. Additionally, this project will provide feedback to the Medical Command and Medial Treatment Facility (MTF) commanders about what changes to expect when operating in a capitated environment.