Investigation into Specialty Payment: Effects on Cost and Treatments

What is the impact of different methods by which health plans pay for speciality physician services (capitation, salary, and fee-for-service) on the cost and quality of those services? Researchers at the University of Washington are analyzing administrative data from three HMOs (Group Health Cooperative in Seattle, Health Partners in Minneapolis, and Kaiser Permanente Rocky Mountain Division in Denver) to determine the effect of the various payment methods on selected procedure rates, cost, primary care referral patterns, and patient outcomes. In addition to examining how the health plans pay for these services, the researchers are attempting to determine how individual speciality physicians are compensated within their own practices or practice organizations. The objective of this study is to provide policymakers and health plan administrators with better information about the impact of various compensation mechanisms on service provision, costs, referrals by primary care physicians, and compensation of specialists.