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'Relative Value Health Insurance' and 'Pay for Performance for Insurers' -- New Proposals are Complements, Not Substitutes
Health Affairs Link to more items from this source
Sept. 21, 2014

"A recent insurance reform proposal, known as Relative Value Health Insurance (RVHI) ... enables insurers to reduce their contractual obligation to cover 'usual and customary' care.... Less well-covered, however, are proposals to alter the very incentives of insurers to improve health, ... 'pay-for-performance-for-insurers' (P4P4I).... P4P4I proposals allow insurers to deny coverage for expensive care that provides few health benefits, but they also incentivize insurers to cover care that they suspect will improve health cheaply. P4P4I faces substantial drawbacks, however, which limit its ability to substitute for traditional health insurance or its RVHI-reformed variants."

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