PubMed · 448322
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
D A Grove, R W Reed, L C Miller. 1979. A health promotion program in a corporate setting.. https://pubmed.ncbi.nlm.nih.gov/448322/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
At a time of debate over physicians' fees and income, we describe the evolution of Blue Shield plans and programs to pay physicians' fees. We review how Medicare's "reasonable-charge" formulas fostered Blue Shield "usual, customary, and reasonable" (UCR) contracts. In a three-year period in the Washington, DC, area, Blue Shield UCR protocols permitted "customary" allowances for selected surgical procedures to rise 29 to 75 per cent; charges by two physicians increased allowances for coronary-artery bypass from $2000 to $3500. We find little justification for secrecy in fee-payment protocols. Physicians dominate the District of Columbia Blue Shield Board and its committees, and they control fee-payment formulas. Nationally, 61 per cent of Blue Shield boards have majorities of health-care providers; approximately two thirds of fee-related committees have physician majorities. We urge increased public debate, public representation, and accountability in monitoring and reforming the programs that we describe.
Explore the source record for details and available documents.
Explore the source record for details and available documents.