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Do financial incentives in a globally budgeted healthcare payment system produce changes in the way patients are categorized? A five-year study.(MANAGERIAL)(Report)

Objective: To assess the responses to financial incentives after a change in the payment system in a capitation-style healthcare payment system over a 5-year period.

Study Design: Cross-sectional and longitudinal examination of cost, utilization, and diagnostic data.

Methods: Using Veterans Health Administration (VHA) administrative data on healthcare users between fiscal years 1998 and 2002, we calculated the proportion of new patients entering each of the payment classes, the illness burden of patients entering the payment classes, and the profitability index (a ratio of payment to costs) for each class suspected of gaming and each control class. Our main dependent ...

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