Re:CVS Is Said to Agree to Buy Aetna
by Consultant32452 on Sunday December 03, 2017 @07:10PM
(#15840469)
The ACA states that your insurance provider must spend 80% of their premiums on health care. The doctor is more expensive, so the health insurance provider is allowed to keep more nominal dollars.
[ Parent
| on HN ]
Although true, I doubt that's the reason since stuff like this was common pre-ACA.
The truth is that everything that a payer pays for is done through contracts. Payers will often default to a specific provider because the contract covers it and they don't have a contract for other providers.
In terms of the cost, back-end rebates often bring it down. Also, this particular contract may cost more for a flu shot, but save them even more for other procedures.