Letter: Urgent care boosted by set-pay capitation

Regarding your recent article on the increase in urgent-care facilities (“They’re popping up everywhere,” Star-Advertiser, Oct. 22), another contributing factor to the increased use of urgent- care facilities is the capitation- type of program HMSA has implemented with many of its participating physicians.

Under this type of program, a physician is compensated a set amount per a set time period for each patient with coverage under that insurance. In other words, the physician is compensated the calculated amount for a patient regardless of the amount of care provided during the set time period.

Consequently, physicians can become incentivized, consciously or not, to be less available to provide care and/or time providing care. Patients not able to see their regular doctors are then pushed to other health care providers such as urgent care providers or specialists.

My experience as a primary care physician has been that patients, regardless of age, generally prefer to be seen by their regular doctor who is able to provide more appropriate care based on knowledge of them and their medical history.

James Lumeng, M.D.

Kailua

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