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Previous Volume 340:321-323 January 28, 1999 Number 4 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Hardman, C. M. Related Article by Pearson, S. D. PubMed Citation

To the Editor: Pearson et al. (Sept. 3 issue)¹ correctly warn that all methods of payment to physicians influence physicians' clinical judgment. But they wrongly portray current risk-sharing capitation arrangements as a mere inversion of fee-for-service payments.

British-style capitation (in which a physician receives a fixed monthly payment for his or her own work) is perhaps ethically akin to fee-for-service. But U.S.-style risk sharing is more analogous to fee-splitting, in which doctors profit from their power to refer. "Anti-kickback" laws ban the payment of physicians for care they prescribe but do not themselves deliver. Risk sharing amounts to a fee-for-nonreferral, . . . [Full Text of this Article]

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