[Mar 06, 98 - 15:29] MARK PROBERT of 1:2619/110 wrote to ALAN RACKMILL:
AR>>This gives the doctor a financial incentive to not refer.
MP> In NY, the practice was that each specialty set up a pool. If a GP 
MP> referred to a specialist more than a certain number of times, that 
MP> specialty pool was "re-imbursed" for the excess "cost". At the end of 
MP> the year, the pools were divided amongst members.
MP> See the pressure?
There have also been rumblings that doctors who refer "excessively" will be 
dropped from this plan or that.  I have no specifics.
My family uses a monstrous clinic which has most of the specialties you'd 
want under one roof.  I'm not sure how it functions, legally, since there are 
individual competing practices within it, but the HMOs treat it as one unit.
The HMOs have been getting their butts kicked a lot lately: they lost a 
drive-through mastectomy fight in the legislature, so they are stepping 
carefully lest they wind up losing all control.
Jerry Schwartz
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