What approach did health plans adopt in response to incentives for unnecessary service provision?

Health plans adopted utilization management programs as a response to incentives for unnecessary service provision. This approach involves implementing systems and practices to monitor, manage, and control the use of health care services. Utilization management aims to ensure that care provided to patients is necessary, evidence-based, and delivered efficiently. These programs typically involve reviewing the appropriateness of proposed treatments, services, and procedures to prevent overutilization or unnecessary procedures that may arise from payment systems encouraging such practices.

By incorporating utilization management strategies, health plans can promote appropriate care while also containing costs associated with unnecessary services. They often employ tools like prior authorization requirements, concurrent reviews, and discharge planning to manage the use of healthcare resources effectively. This approach serves to align incentives with the goal of improving the quality of care and outcomes for patients, as opposed to merely increasing service volume.