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Sustainable provider payment arrangements: What are the key elements conceptually?

ByJill Van Den Bos
3 October 2010
In the 1990s, managed care programs faced a series of difficulties. Providers who accepted risk experienced financial trouble and consumers resented and abandoned plans that placed limits on access and choice, leading to a perception of medical care rationing. These problems resulted in a widespread return to fee-for-service reimbursement and an escalation in medical utilization and costs. Now, insurers and their employer clients are looking for ways to shift some financial risk back to providers as a way to encourage the alignment of incentives to achieve better care delivery. This paper takes a brief look at the shortcomings of provider payment during the 1990s and considers payment arrangements that may make provider risk sharing sustainable in the future.

About the Author(s)

Jill Van Den Bos

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