An investigation of the effects of capitated compensation for primary care on healthcare utilization of medicare beneficiaries

This research is unique in that it evaluates annual healthcare utilization based on the risk-bearing capitated reimbursement for patients' PCPs. Other research has not found a strong correlation between value-based reimbursement, healthcare utilization, and cost savings. This article demonstrates significantly less healthcare utilization for patients when PCPs receive greater risk-bearing capitated reimbursement. However, services received from a PCP were greater for these patients.

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Publication Details

Journal
Journal of Health Organization and Management
Published
2025-11-03
DOI
https://doi.org/10.1108/jhom-01-2025-0034
Primary Topic
Primary Care and Health Outcomes
Type
article
Field-Weighted Citation Impact
0.00
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article

An investigation of the effects of capitated compensation for primary care on healthcare utilization of medicare beneficiaries

L. Douglas Smith, Michael R Wieck, Steven R Stout
Journal of Health Organization and Management
Primary Care and Health Outcomes
article

An investigation of the effects of capitated compensation for primary care on healthcare utilization of medicare beneficiaries

L. Douglas Smith, Michael R Wieck, Steven R Stout
article en

Abstract

This research is unique in that it evaluates annual healthcare utilization based on the risk-bearing capitated reimbursement for patients' PCPs. Other research has not found a strong correlation between value-based reimbursement, healthcare utilization, and cost savings. This article demonstrates significantly less healthcare utilization for patients when PCPs receive greater risk-bearing capitated reimbursement. However, services received from a PCP were greater for these patients.

Journal of Health Organization and Management
University of Missouri–St. Louis (US), Endeavor Charter School (US), Indiana University Southeast (US)
Openalex Percentile: Top 50%
Primary Care and Health Outcomes
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