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Originally Posted by InDebtInDC
To rebut your assertion, I have worked with hundreds of physicians who prefer capitation over FFS. The main rationale for those physicians is that they do not want to feel like an assembly line.
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Another advantage of capitation is cash flow. If I have 100 patients from Plan XYZ and I am contracted at $40/month/patient, I know I will get a $4,000 check each month no matter what. With fee for service, if I have a slow month or happen to have relatively uncomplicated patients, I can see a drop off in income even though all my overhead bills stay pretty much the same. With capitation, I also don't have as many billing hassles.
Most plans today blend capitation and FFS. We are capitated for basic care but there is still a fee schedule for procedures above and beyond what is covered by the capitation payment.
Copays are another thing that has changed for the better (for the doctor). I remember when most of my HMO patients had $2 copays. On a busy day, I might take in $80 from seeing 40 patients. Today, however, most copays are $15 or more. Seeing those same 40 patients now results in $600-800 collected in copays. And that is on top of the monthly capitation payment covering those patients.
So capitation isn't such a bad thing IMO. Sure, FFS is generally more lucrative, but it isn't perfect either. I think you'll find that most docs accept some combination of FFS and capitated plans.