Insurers pay docs to stick to regimens
Insurance companies are getting more closely involved with cancer treatment options. The Wall Street Journal reports that the strategies include WellPoint's latest rollout—a $350 per-month, per-patient incentive for doctors who adhere to the insurer's recommended regimens—as well as insurer Highmark, which eliminated the pay reimbursement differential between hospital and in-office settings. Highmark's chief medical officer said they found they were being charged hospital rates even when a medication was given at an office, saying “they simply relabeled the room” to get the higher reimbursement rate.
WellPoint estimates that the program will end up saving the insurer around $5.4 billion. The company told the WSJ that its policy will not clash with genetics-based protocols and that it will not punish doctors for using treatments that are not on its recommended list.