Regarding the effects of captive insurance
Excerpt taken from the Spine Minds discussion: Grade I Degenerative Spondylolisthesis: To Fuse or Not to Fuse? (Part 1)
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I’ll give you an example of something that happened this week. Not only affecting the individual surgeon who has shown expertise in a particular spinal procedure, it radically affects the patient.
A patient I saw this week works for a large industrial group. His insurance plan has a tiered system of payment that’s reflected in co-pays and deductibles. If he goes to a Center of Excellence in Tennessee, the plan payment/copay is 90%/10%, with 10% being the copay that he will have to pay. If he goes to a non-center of excellence or somewhere else the payment/copay is 80%/20%.