Blue Cross targeted its "rat out" letters to capitated doctors

That’s an interesting revelation. Physicians in a capitated system have a financial incentive to deny care to the most complex patients:

In other words, the Blues sent these letters only to doctors who might be as interested as Blue Cross, from a financial standpoint, in ridding the system of expensive patients. As in every good business model, the incentives of the parties (i.e., Blue Cross and the physicians) lined up perfectly.