Primary Care Physicians' Satisfaction with Quality of Care in California Capitated Medical Groups

Published In: Journal of the American Medical Association, v. 278, no. 4, July 23, 1997, p. 308-312

Posted on RAND.org on January 01, 1997

by Eve A. Kerr, Ron D. Hays, Brian Mittman, Albert L. Siu, Barbara Leake, Robert H. Brook

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Examines primary care physicians' satisfaction with quality of care in California capitated medical groups. A total of 90 California physician groups participated in this study, and a total of 910 primary care physicians responded to a survey about satisfaction. Four aspects of quality care related to patients covered by capitated contracts as opposed to patients overall. The primary findings in this study were that California primary care physicians were less satisfied with the quality of care they deliver to patients covered by capitated contracts than with the quality of care they deliver to patients covered by other payment sources. However, those in medical group practices and with a higher percentage of capitated patients were more satisfied with capitated care. In particular, 71% of physicians were very or somewhat satisfied with relationships with capitated patients, compared with 88% for their overall practice; 64% were very or somewhat satisfied with the quality of care they provided to capitated patients compared with 88% for overall practice; 51% were very or somewhat satisfied with their ability to treat capitated patients according to their own best judgment, compared with 79% for overall practice; and 50% were very or somewhat satisfied with their ability to obtain specialty referrals, compared with 59% for overall practice. Based on these two findings, our recommendation is that national expansion of capitation be accompanied by efforts to ensure that the satisfaction of practicing physicians with the care they deliver does not decline. Thus, according to the perceptions of physicians, capitated patients do receive different services, and these differences result in different levels of satisfaction.

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