PPO & Their Hospital Partners Push Back Against Cost Plus Insurance Plans

Letter to HealthSpan customers brokers and TPAs_Nov 2012

Editor’s Note: Cost Plus Insurance (www.costplusinsurance.com) is gaining market acceptance by plan sponsors desparate to reign in ever increasing health care costs. Providers are guaranteed a profit margin in excess of their cost-to-charge ratios as reported to CMS. Employing a magic wand, balance billing issues are “poofed away”, and plan sponsors are legally immune.

PPO’s and their provider partners should take note that critical thinking is the capacity of a person to distinguish claims (I have great discounts!) from evidence (our costs keep going up year after year).    Managed Care Under Siege

Cost Plus Insurance – “Don’t bother doing something unless your radically different from the competition” – Richard Branson