Look at Kaiser; they run a vertically integrated shop. They're fanatical about

• not paying for any elective treatments even if it would improve quality of

• preventive care to cover all the diseases they're legally required to cover

• minimizing org-to-org friction

• using the cheapest means of communication whenever possible (text > video >> in-person)

I never had my blood pressure and lab work more scrutinized, never had more help offered to lose weight, etc, than when I was a KP patient.

Turns out I have special medical needs and there is a specialist clinic near me, so I switched insurance. But I always felt that my doctor wanted to keep my ass out of the hospital because that is where his bonus came from.

Now SURGEONS, that's a different story.