A Survey of the Attitudes of Physician Specialists Toward Capitation-Based Health Plans with Primary Care Gatekeepers

Abstract

A survey of 414 Washington state physicians board certified in one of seven non-primary care specialties (gastroenterology, cardiology, dermatology, otolaryngology, orthopedics, psychiatry, and general surgery) assessed physician attitudes towards capitation-based health plans with primary care gatekeepers. Responses indicated significant differences in attitude according to specialty. Negative attitudes were more prevalent among physicians in solo practices and those practicing in smaller communities and were related to quality of care provided, lack of information regarding benefits, loss of physician autonomy, and heavy administrative demands in these plans. Although most respondents disapproved of capitation-based health plans, a significant number agreed that gatekeeper-based plans serve to increase public awareness about health care costs as well as to control health care costs.