Should Medicare Place Physician Groups at Financial Risk: An Assessment ofAlternative Demonstration Strategies

摘要

This report assesses the feasibility and desirability of conducting ademonstration in which physician groups would be at financial risk for services provided under Medicare and discusses key design issues that would have to be addressed in developing such a demonstration. Based upon a literature review and discussions with key health industry and Government representatives, the report suggest that such a demonstration would be feasible given the experience that many physician groups have gained accepting financial risk from HMOs and the high level of interest expressed by some groups provided that they are at risk for some inpatient care. The authors identify major obstacles would have to be overcome for a successful demonstration: potential regulatory requirements imposed by state insurance departments and the need for physician groups to offer incentives (i.e. supplemental benefits) for beneficiaries to enroll.