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Use lessons learned from capitation to improve managed care performance

Results of the 2008 Capitation Survey conducted by the American Medical Group Association in Alexandria, VA, and Seattle-based ECG Management Consultants, Inc., offer some valuable benchmarks and suggest that lessons learned from capitation can be applied to other types of managed care contracting and management. Consider Dreyer Medical Clinic in Aurora, IL, a multispecialty group practice with 143 physicians that serves the suburban communities southwest of Chicago. Approximately 38% of the organization's patients are currently enrolled in capitated plans. Charles Derus, MD, the clinic's medical director, calls capitation a "beautiful thing in a recession" because the contracts continue to pay steady per-member per-month payments. He isn't confident that reimbursement will remain as stable on the fee-for-service side of the books.