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New trend: Tiered doc networks; pay top premium for top doctors

by on
in Employee Benefits Program,Human Resources

First came tiered drug benefits, in which employees paid higher co-payments for expensive prescriptions. Then came tiered hospital benefits, in which they paid more for costlier facilities. Now, according to the Employee Benefit Research Institute, it's tiered doctor networks.

How they work: Insurance companies rate doctors based on cost, quality of service and patient satisfaction. You'll pay more to visit the best docs. The goal: Encourage employees to use low-cost providers to reduce their premium costs.

Premera Blue Cross in Washington and California's PacifiCare launched tiered doctor plans this year. Aetna will introduce a plan in 2004. Others will follow.

The key: For tiered networks to lower premiums companywide, the minority of employees who account for the bulk
of health care costs must choose the most efficient doctors.

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