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Insurers cap what they’ll pay for some procedures.
Washington Post

Aiming to contain health-care costs, a growing number of employers and insurers are limiting how much they’ll pay for such things as knee replacements, lab tests and complex imaging. A recent study found that the resulting savings may be modest, however, and some experts question whether reference pricing, as it’s called, is good for consumers.

The California Public Employees’ Retirement System (Calpers), which administers the health insurance benefits for 1.4 million state workers, retirees and their families, has one of the more established reference pricing systems. More than three years ago, the agency began using the approach for elective knee and hip replacements; hospital prices for these two common procedures varied widely without discernible differences in quality, says Ann Boynton, Calpers’s deputy executive officer for benefit programs policy and planning.