The use of P4P has helped Wellpoint, one of the nation's largest health plans with more than 28 million members, improve immunization rates to 58% from 21% and pap smear rates to 85% from 79%.
The use of P4P has helped Wellpoint, one of the nation's largest health plans with more than 28 million members, improve immunization rates to 58% from 21% and pap smear rates to 85% from 79%.
Prepaid medical groups like Grand Valley Health Plan, Grand Rapids, MI, are facing declining membership as employers shift to lower-priced PPOs. But some employers are starting to look more closely again at the value of managed care networks.
Capitated contracts have become much more complex with new provisions for gain-sharing, pay-for-performance incentives, carve-outs, and updates for new technology, pharmaceuticals, and injectables. Use these strategies to protect your organization in today's risk contracting environment
An independent practice association has sued Humana Kansas City Inc. over the health plan's decision to terminate its capitated contract. The suit alleges breach of contract and seeks an injunction to keep the flow of capitated dollars coming.
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