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Doody's Review ServiceReviewer: Eugene C. Rich, MD (Creighton University Medical Center)
Description: This multi-authored book provides a textbook for provider sponsored organizations on capitated contracts.
Purpose: The editor indicates that this work is to serve as a primer for provider sponsored organizations, primarily those established under the 1997 Medicare legislation.
Audience: The intended audience includes physicians and administrators of physician organizations interested in establishing provider sponsored organizations.
Features: This book covers a spectrum of issues relevant to providing capitated care through provider sponsored organizations. The topics range from introductory sections on capitation and outcomes management to discussions of legal issues and general steps in setting up a Medicare risk contract through a provider sponsored organization. It includes a glossary of terms relevant to Medicare HMOs and provider sponsored organizations. It concludes with an appropriately detailed index.
Assessment: This book suffers from an inconsistent focus. While the editor states that it is presented as a tool kit for physicians and other providers interested in establishing provider sponsored organizations, many of its chapters are general and superficial. There are a number of other works which more thoroughly address issues of integrating physician practices and managing capitated risk. Although the proposed focus on Medicare provider sponsored organizations is laudable, the content in this area is incomplete. It is particularly unfortunate that this was published prior to the Health Care Financing Administration June 1998 release of specific regulations on direct Medicare contracting by provider sponsored organizations (published January, 1998).