HEALTH CARE

Forging Ahead: Capp Care Inc., a Fountain Valley-based managed health-care company, is entering its second year of an innovative, five-year demonstration project for Medicare beneficiaries in Orange County.

The project, which the federal Health Care Financing Administration awarded to Capp Care in the spring of 1990, established a preferred provider organization of selected Capp Care physicians--who must have conservative billing histories, agree to accept Medicare fees as full payment, and receive prior approval to perform many procedures and treatments.

Any Medicare beneficiary in the county is eligible to participate in the program, and automatically does so if he or she makes use of one of the 867 physicians listed in Capp Care’s PPO demonstration-project directory, a copy of which was mailed last year to every Medicare patient in the county.

The pilot project offers patients an alternative to traditional fee-for-service care--in which Medicare patients often must pay an additional amount beyond the government reimbursement--and HMO subscription plans, said Capp Care president Edward Zalta.

The goal of the project, Zalta said, is to keep a lid on Medicare costs while still offering patients a wide range of choice among competent physicians.

Zalta said he could not yet reveal the financial results of the project, but Medicare beneficiaries seem to be responding. In the first year of the program, 60% of all Medicare patients in the county visited the project’s doctors.

Zalta said Capp Care is about to expand the project to Los Angeles.