001 physician in health care 02 18 10 07 wmv

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Physician in Health Care Organizations (HCOs)
Helps FPGEE NAPLEX Exams
TRADITIONAL Roles of physician:
Self-employed
Solo practice
Single specialty groups
Fee-for-service reimbursement for care of individual patients
Open access to any doctor
Autonomy
Roles of physician during MANAGED CARE ERA :
Employed (then privatized)
Group practice
Multi-specialty groups
Capitated for care of a population (shared $ risk)
Primary care physician gatekeeper (wax and wane)
Accountability
Physician payment models:
TRADITIONAL Model: fee for service only (work more-earn more)
CAPITATION Model: fixed payment per member per month (pmpm) (work less - earn more)
FUTURE Model: fee-for-benefit & performance-based contracting

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