Insurers and Providers Meet Halfway in Compliance with WellPoint's New Program


Insurance heavyweight, WellPoint, is offering monthly bonus installments of $350 to Oncologists who adhere to approved treatment protocols. This a strategic effort to curb the increasing costs of cancer care. The program is expected to begin July 1st of this year, starting in six states across the country, as stated in a Wall Street Journal report.

While payments are made only when patients are treated in accordance with certain pathways, WellPoint expects these recommendations will apply to 80-90% of patients. Concerns have been raised, however, that such payment plans would interfere with certain patients' treatment. According to Dr. Brian Bolwell, chairman of the Cleveland Clinic's Taussig Cancer Institute, Oncologists at their organization "like to practice based on their patients, not insurance companies."

The new program is expected to yield significant cost reductions for the insurer. WellPoint estimates "savings of 3 percent to 4 percent of cancer treatment costs" which amounts to hundreds of millions of dollars per year, says the report.

The current system encourages doctors to maximize billing revenue, which often leads to more expensive and unnecessary procedures. WellPoint’s bonus program cuts against that grain by rewarding doctors for increasing their efficiency. Look for more insurers to begin offering similar incentive programs to deliver additional value to doctors.

By: Tyler Kehoe

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