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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
by Consultant32452 9y ago
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.
- refurb 9y agoAlthough 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.