20% of Massachusetts Residents on Insurance Plans That Budget Physician Spending

About one in five Massachusetts residents are being treated by physicians working on a budget created by insurance plans to restrain health spending, according to a Boston Globe report.

A Globe survey found that 20 percent of residents are treated by physicians on such plans, even before state lawmakers begin debating legislation to address soaring health insurance premiums. Part of the strategy to reduce premiums is to encourage such plans.

The state's four largest health insurers — Blue Cross Blue Shield, Harvard Pilgrim Health Care, Tufts Health Plan and Fallon Community Health Plan — have now assigned more than 1 million members to health plans that endanger physician revenue if they exceed their budgets for patient care. Providers can also earn extra profit if they spend less than their budget.

The plans are intended to control rising health insurance premiums by incentivizing physicians to use less expensive procedures. The plans also aim to increase the use of preventive care rather than more expensive medical treatment to treat a more developed condition.

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