Washington plan starts tiered network for physicians

Article Abstract:

Premera Blue Cross in Washington is introducing a managed care network that uses cost measurements to assign physicians to tiers deciding where to place large physicians according to how well they score on cost efficiency. The plan called Dimensions is profiling costs at large clinics across the state, representing about 15% of all physicians in the Premera system.

Services information, Services, Practice, Premera Blue Cross

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Managed care easing gatekeeper hassles

Article Abstract:

Referrals have been an obstruction to providing necessary care, as physicians have to spend huge sums just to take care of patients whose health plans require a primary care referral in order to see a specialist. As a result, some health plans are dropping the so-called gatekeeper model that has been a bulwark of managed health care.

Health Care and Social Assistance, Health Planning, Management, Company business management

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