Interactions Among Payment Programs and Between Payment Programs and Government Regulations

In a pluralistic health care system, typical physician practices have contracts with a variety of different health plans, each of which applies its own payment model. In this context, the effects of each health plan’s payment model might depend not only on the model itself but also on how it interacts with the payment models used by the other payers. One clear finding from our interviews was that the multiplicity of PFP and other incentive programs has created a heavy administrative burden on some physician practices. Merely keeping track of payment program details, which vary from payer to payer, required