Controlling Health Care Costs through Commercial Insurance
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چکیده
Commercial insurance companies' have the market incentives and the ability to take on a new role as controllers of rising health care costs. This Note will discuss the market for insurer-directed cost containment, the types of cost control alternatives that could be utilized and the legal restraints on insurer innovation. The analysis of the legal setting for insurer innovation in cost control includes an exploration of rules governing the corporate practice of medicine, the physician-patient relationship, Blue Shield laws, specific mandatory policy provisions and coverages, judicial extension of coverages, the effect of the Employee Retirement Income Security Act (ERISA) on employee health insurance plans, and antitrust implications of insurer innovation.
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