Blue Cross to offer North Carolina members up to $500 rebate for choosing cheaper physician


BlueCross BlueShield of North Carolina will offer some members a cash rebate for choosing cheaper physicians and procedures, according to The Herald-Sun.

The rebates, which range from $25 to $500 per medical procedure, are only available to companies that pay for their employees' health insurance, in which case Blue Cross only administers the plan. Rebates will be issued for more than 100 procedures, and the amount of the rebate will depend on the complexity of the procedure and the cost savings form choosing a cheaper option, according to the report.

BCBS of North Carolina will use SmartShopper, a cost and quality transparency service, to help members achieve cost savings. It costs employers between $2 and $4 per employee per month to provide access to SmartShopper, regardless of whether the employee uses the service.

SmartShopper lists all physicians in Blue Cross' network as "high quality," which has some medical professionals concerned.

"I know of surgeons on their plan who have lost their [practicing] privileges at hospitals but still were on the [health insurance] plan, how does that define quality?" Michael Haglund, MD, who specializes in spinal fusion procedures at Duke University Medical Center in Durham, N.C., told The Herald-Sun. "Still sounds pretty odd to me, just a way to pressure policy holders to choose to roll the dice with less qualified and not as highly ranked surgeons."

However, Blue Cross defended the standards used to evaluate physicians.

"While many studies have shown there is no correlation between cost and quality when it comes to healthcare, all doctors listed meet strict standards required to be part of the Blue Cross NC network, including verification of their credentials being in good standing and meeting state licensure requirements," a company spokesperson said in a statement to The Herald-Sun. "The costs listed also take quality measures into account as they represent the entire cost of the procedure, including such factors as efficiency, the length of hospital stay and the number of medical professional [sic] involved in the procedure."

Access the full article from The Herald-Sun here.

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