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Have you got what it takes to survive managed care? Maybe it’s hard to know if you were never really trained in managed care in general, or capitation in particular. With that in mind, three researchers have developed a protocol of specific clinical competencies for effective managed care practice.1
In addition to developing a useful protocol, researchers surveyed four groups of physicians to determine what would be important in training physicians for capitation and its related hybrids. They surveyed 790 physicians — residency program directors, residents, managed care directors, and primary care residency program directors in areas of high managed care penetration. Response rates in each group ranged from 67% to 94%.
Ultimately, they learned that all four groups place a high priority on the emerging new skills of risk-based practice management and patient care, and that what counts most is making it all work. The most successful approach, researchers found, requires a balancing act of four main areas — patient care, performance monitoring, teamwork and coordination of care, and organizational issues.
These findings bode well for the future of capitation and other managed care systems approaches, say Michael J. Yedidia, PhD, and Colleen C. Gillespie, PhD, both professors of health and public service at New York University in New York City, and Gordon T. Moore, MD, a physician at Harvard Pilgrim Health Care in Boston, who conducted the surveys.
"While recent surveys have documented considerable disaffection toward managed care among academic physicians, this negativism does not appear to have carried over to their views on the importance of teaching specific managed care tasks related to population health," the researchers write. "In spite of fundamental differences on other health care issues, our findings indicate that residency directors and MCO medical directors place high importance on specific clinical behaviors and that they share a similar vision of priorities for applications to future medical practice."