Capitation Payment for Pharmacy ServicesI. Impact on Drug Use and Pharmacist Dispensing Behavior
作者:
Charles Yesalis,
David Lipson,
G Joseph Norwood,
Dennis Helling,
Leon Burmeister,
Mark Jones,
Wayne Fisher,
期刊:
Medical Care
(OVID Available online 1984)
卷期:
Volume 22,
issue 8
页码: 737-745
ISSN:0025-7079
年代: 1984
出版商: OVID
关键词: Medicaid;pharmacy;drug utilization;financing;capitation;reimbursement;quality assessment
数据来源: OVID
摘要:
Results of a two-county pilot study in Iowa revealed that capitation may have significant advantages over fee-for-service (FFS) reimbursement in the Medicaid drug program. Consequently, the capitation program was expanded to 32 counties on April 1, 1981 and continued through December 31, 1981. Another 32 counties were used as part of a before: after/experimental: control design. Pharmacists were paid 80% of projected drug expenditures in advance based on the types of Medicaid eligibles who chose them as their providers. The remaining 20% was withheld in an escrow account to be used for supplemental, emergency, and bonus payments. Pharmacists who participated in this experiment were guaranteed that their gross profits on Medicaid prescriptions would remain at least equal to what they would have been if they had remained under the current FFS payment system. Major differences in drug use levels and pharmacist dispensing behavior under capitation financing were observed in the pilot study. However, no such changes associated with payment type were noted in the expanded program. Relative to these findings, a discussion of pharmacist attitudes is presented.
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