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Insurers introduce new payment structures to reduce costs

In an effort to cut healthcare costs, several insurers are introducing new pay structures to encourage care that averts hospitalizations, including paying enhanced fees to hospitals.

Aetna plans to pay a major San Diego medical group enhanced fees for providing extra services to keep patients healthier and to share any resulting cost savings. UnitedHealth is basing payments to its network providers partly on cost and quality measures, and Cigna guarantees corporate clients it will lower employee health risks, accoring to the Wall Street Journal.

Cigna found broad efforts encompassing prevention and disease-management programs, cost- and quality-based provider networks, and consumer engagement saved 15 percent.

The health plans are also "offering employers narrower, lower-cost provider networks, prodding enrollees to form healthier habits and pick less expensive doctors, and getting tougher in hospital price negotiations," notes the Journal. For example, a new UnitedHealthcare plan provides financial incentives for diabetics who commit to certain behaviors.

Additionally, insurers are providing online cost and quality comparisons for consumers, a tool particularly helpful for surgical procedures ranging widely in price.

"The best discount and the best way to lower costs ... is to obviate the need for the hospitalization all together," Aetna's chief medical officer Dr. Lonny Reisman told the Journal.

To learn more:
- read the Wall Street Journal article

Related Articles:
California hospitals to begin bundled-payment demo
Could capitation be the hot new payment trend
WellPoint, Aetna, and Humana pilot remote monitoring to cut readmissions

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