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Calif. J. Politics Policy 2014; 6(2): 245247 Commentary Bruce Bodaken* Keywords: accountable care organizations; commercial insurance; integrated care; physician leadership; prevention; risk-adjusted global budgets. DOI 10.1515/cjpp-2014-0022 "A New Vision for California's Healthcare System: Integrated Care with Aligned Financial Incentives," the Berkeley Forum Report issued in 2013, addresses the fundamental issues that determine the quality and cost of health care in California. The Forum Report envisions a significant improvement in cost and quality if certain initiatives are implemented. This commentary addresses the Forum's key initiative, which is to increase the number of people getting care from integrated systems that operate under risk-adjusted global budgets and the path to achieving 70% of enrollees receiving care under such systems.1 The initiative has two components care provided by an integrated system and delivered for a fixed payment, i.e., a "global budget" under which costs are fixed regardless of the volume of services delivered. California has been a national leader in shifting financial risk to providers under fixed payments, specifically "capitation." Multispecialty medical groups and some Independent Practice Associations (IPAs) have been delivering care under fixed payments since the mid-1980s. 1The risk-adjust global budget/integrated care system initiative is one of seven initiatives
California Journal of Politics and Policy – de Gruyter
Published: May 21, 2014
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