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The case management restrictions must not "substantially impair access" to primary care services of "adequate quality where medically necessary"; and; The case management restrictions must be "cost effective". [2] In their earliest forms, PCCM programs closely resembled traditional fee-for-service Medicaid than managed care.
The amount of involvement an insurer can have in managing high cost cases depends on the structure of the benefit plan. In a tightly managed plan case management may be integral to the benefits program. In less tightly managed plan, participation in a case management program is often voluntary for patients. [5]
In 1972, The two firms, then known as Blue Cross of Indiana and Blue Shield of Indiana, entered into a joint operating agreement. [9] In 1985, The two companies merged into Associated Insurance Companies, Inc,, later called, The Associated Group, a holding company, but usage of the name "Anthem" persisted. [10]
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