Association Between Capitated Payments and Preventive Care Among U.S. Adults.

Autor:	Morenz AM; Department of Medicine, University of Washington School of Medicine, Seattle, Washington.; Value and Systems Science Lab, Seattle, Washington., Zhou L; Department of Medicine, University of Washington School of Medicine, Seattle, Washington.; Value and Systems Science Lab, Seattle, Washington., Wong ES; Value and Systems Science Lab, Seattle, Washington.; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington., Liao JM; Department of Medicine, University of Washington School of Medicine, Seattle, Washington.; Value and Systems Science Lab, Seattle, Washington.; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington.
Jazyk:	angličtina
Zdroj:	AJPM focus [AJPM Focus] 2023 Jun 01; Vol. 2 (3), pp. 100116. Date of Electronic Publication: 2023 Jun 01 (Print Publication: 2023).
DOI:	10.1016/j.focus.2023.100116
Abstrakt:	Introduction: There is increasing interest in using capitation rather than fee for service to promote primary care and population health. The goal of this study was to examine the association between practice reimbursement mix (majority fee for service versus majority capitation versus other) and receipt of common preventive screening examinations and health counseling from 2012 to 2018. Methods: Using the National Ambulatory Medical Care Survey, a retrospective cross-sectional study of 24,864 visits with primary care clinicians among patients aged 18-75 years without a cancer diagnosis was conducted. The main dependent measures were age- and sex-appropriate receipt of breast cancer screening, osteoporosis screening, cervical cancer screening, chlamydia testing, colon cancer screening, diabetes screening, and hyperlipidemia screening as well as 3 health counseling items. Multivariable logistic regression was performed to assess the association between reimbursement mix and receipt of preventive care, adjusted for patient, visit, and practice characteristics. Results: Majority capitation reimbursement was associated with a greater likelihood of receiving breast cancer screening (AOR=2.11, 95% CI=1.16, 3.84, p =0.014) and osteoporosis screening (AOR=4.34, 95% CI=1.74, 10.8, p =0.0017) than majority fee-for-service or other reimbursement mixes. Reimbursement mix was not associated with the likelihood of receiving 9 other preventive care or health counseling services. Conclusions: Larger amounts of capitation reimbursement may improve some but not all aspects of preventive care compared with fee for service. (© 2023 The Author(s).)
Databáze:	MEDLINE
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