As an example, many employers have opted in recent years to send all their major heart cases to Cleveland Clinic. Their bundled prices are at or below the market median and their quality is provably and acknowledged to be tops. But here’s the kicker: They do not operate based on the diagnosis given them. They do a complete workup of their own — a second opinion. As a result, they send 30% of the cases home without operating, as their diagnosis shows that more conservative treatment is warranted. The docs there are not paid per operation, so they don’t need the volume. They tell me this means they can focus on the highest quality healthcare.
So in an ideal system second opinions from the tops in the field would be highly valued by payers, as they often lead to better outcomes at lower cost (as in your case).