2010 Articles

Uniform Plan-Provider Contracts: A Proposal to Reduce Expenses of Health Plans, Health Care Providers and the Public

Swidler, Robert N.

The article explains that states could significantly cut expenses by health plans, health care providers and the public, and benefit health plan members greatly, by developing uniform plan-provider contracts without rate sheets, and requiring the use of those contracts by health plans and health care providers. Plans and providers would still negotiate reimbursement methodologies and rates, but all or most other terms would be prescribed. For some contractual matters the uniform plan-provider contracts could offer alternative terms, but with prescribed language for those alternatives.