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100 percent according administrative annual audit benefit plans bill Blue Cross Blue Cross-Blue Shield Business California carrier Cassavant changes charges Citibank city's claims co-payments concurrent review corporate cost containment cost shifting cost-effective covered deductible delivery system develop director effective efforts employee benefits employee health encourage expenses fees firms Florida fund gram health benefits health care costs health care delivery health care system Health Costs health insurance health maintenance organizations health plan incentives increase individual initial inpatient issues labor Lifestyle major Massachusetts McElveen Medicaid Medicare Member/Participant ment million negotiating options outpatient participants patients payment Pepsico physicians plan design ployees pre-admission preferred provider preferred provider organization premiums problem procedures provider organization Recommendation reduce reimbursement risk Rosmann savings second opinion self-insurance state's strategy surgery Task Force tion tive union utilization review workers