Insurers and Health Care Cost--NY Times Opinion

How Insurers Can Help  Unsigned Editorial.  New York Times.  October 1, 2012.

In this opinion piece, the editors of The New York Times cites an innovative program by Blue Cross and Blue Shield of Massachusetts aimed at reducing health care costs.  Under this program many of the states largest hospitals and physician groups are placed on fixed budgets with incentives, both positive and negative, to meet budget targets in care.  This contrasts with a fee-for-service approach which compensates doctors for each service they provide.  Fee-for-service is often criticized for encouraging doctors to do more rather than less.  Under the new approach insurers do not dictate what procedures or tests that are to be performed.  These decisions are left to doctors to work within the resources provided.    To prevent doctors from denying care to meet budget targets, bonuses are provided patient achievements in areas such as blood pressure control.  Costs thus far have been controlled by using low-cost hospitals and non-hospital laboratories which are often cheaper.