A study from Health Affairs comparing Medicare costs in two Texas towns to those of private pay patients showed that health insurers actually save money. Why?
Among the tactics used by BCBS that might not be employed by Medicare, according to Franzini, are preauthorizations, provider utilization monitoring, case management efforts and stepped up prevention and wellness programs and incentives. In other words, meddling in provider (and patient) decision-making is effective … at least in some cases.
Chalk one up for health plans and their contentious rules which require physicians to clear procedures and medications before they are delivered.
http://www.healthleadersmedia.com/page-2/HEP-260971/Health-Plans-Data-Proves-that-Meddling-Works
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