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- W161246196 abstract "Rarely in health policy has so much been expected by so many from so few. Prepaid group practice (PGP) has been conceptualized by its sponsors as combining the organizational locus for physician collegiality with the economic incentives for practice efficiency and the marketplace context for informed, pricesensitive consumer choice.1 Through various methods in various markets, prepaid group practice has achieved these goals, exerting a dramatic effect on the structure and performance of the health care system. It has moderated cost inflation, enhanced coverage for preventive services, focused attention on chronic disease management, and more generally, demonstrated that America can do better than a fragmented system of independent practitioners, piece-rate payment, and uninformed, cost-unconscious consumer choice.2 Yet without doubt, the penetration and performance of prepaid group practice have fallen short of the anticipations of its advocates and even of the more cautious predictions of purchasers and policymakers. After rising for two decades, the tide of consumer enrollment, entrepreneurial energy, and political interest has ebbed to the point where textbook PGPs are difficult to locate. Kaiser Permanente maintains a strong position on the West Coast, and hybrid entities that embody some, but not all, of the elements of prepaid group practice are to be found in many metropolitan areas. But the trend in the health care marketplace is toward broad network insurance products divorced from provider systems, retrospective rather that prospective payment, a purchasing CHAPTER TEN" @default.
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- W161246196 date "2004-03-12" @default.
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- W161246196 title "The Limits of Prepaid Group Practice" @default.
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