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From Managed Care to Higher Costs for Patients to Insurer's Provider-Cost-Containment Measures to Provider Backlash
The Century Foundation
May 8, 2009
Excerpt: Insurers have focused on business practices that include delaying payments to providers, 'bundling' several procedures and then reimbursing at a lower rate, and underpayment of services provided outside the network. These newer cost-containment measures have now raised the ire of providers. According to an article written by Maureen Glabman in the February 2009 issue of Managed Care, class-action lawsuits filed by providers against all of the major health plans have nearly tripled from the late nineties to the first five years of this century. According to Glabman, these suits already have resulted in combined, multi-billion dollar settlements-- and there are many similar cases still working their way through the court system. Angry providers, backed up by the American Medical Association (AMA) and state medical societies, are 'empowered as nearly anonymous members of class action lawsuits,' observes Glabman, to try and fight carrier business practices they feel are depriving them of income.
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