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.

You must be a registered member of MMM to post a comment.
close

Next Article in Channel

 

Did you miss January's Top 40 Healthcare Transformers issue? Read how these inventors, strategists, entrepreneurs and wonks are challenging, disrupting and otherwise transforming the healthcare business. And join us April 30 to honor them at the Transforming Healthcare Dinner. Click here.