The vice president of an innovative community hospital is proposing a plan focusing upon family practitioners to deliver an integrated health delivery system. A key issue is how to alter the incentive/compensation plan from fee-for-service (i.e., piece rates) to a schedule based on capitation (i.e., guaranteed income based on serving all the health needs of a defined population). The teaching purpose is to examine change management issues in a very complex, political environment involving professionals and develop appropriate metrics of physician accountability.
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