Castlight Insight Series
Many consumers believe that going to in-network providers leads to the most affordable care. Castlight Health investigated this to understand what level of price variance individuals can expect when comparing costs for common medical procedures among in-network providers.
Many health plans designate selected facilities with special recognition intended to signify procedure-specific quality, such as “Centers of Excellence” (COEs). Castlight Health compared these quality designations with publicly reported quality metrics to evaluate the extent to which health plan designations of procedurespecific quality align with nationally reported quality metrics.
Pre-authorization is often required by third-party payers to reduce overutilization of unnecessary health services. Castlight Health evaluated utilization data for common diagnostic imaging tests among employees of self-insured employers. These employers’ third party payers had instituted pre-authorization and utilization management programs.