Again, this is already happening. Hospital side care providers use systems which optimize for expected payout value. That increases payout totals and insurance costs for everyone.

The ACA tried to make health outcomes a part of the calculation for everyone involved but it is hard to compete with the all mighty dollar.

"Repricers" work on both sides of the equation - providers and provider networks use them to maximize the procedure codes around an ICD-10 diagnosis code.

And insurers use them to minimize the list of procedures they'll accept and pay for around a given ICD-10 code.