Medicare Model Helps States Control Costs – Within Limits


A cost-negotiation approach similar to the one used by the federal Medicare program has saved states like Montana and New Jersey millions of dollars negotiating their state employee health insurance plans. In Montana, the state fired its major insurance carrier and set the rates it would pay health providers for care and procedures, rather than vice versa. In New Jersey, a much bigger state, the program was modified by requiring hospitals and providers to reveal its prices and then grouping hospitals by zip code and asking the state's big insurance carrier for bids geographically on that basis.

Related Stories