CalPERS Mulls Fee Increases To Offset Health Care Costs
The health care consultant for CalPERS on Wednesday recommended that the pension system confront rising health care costs by increasing copayments for its members, the Sacramento Bee reports. The board last year rejected a proposal to increase copays.
Milliman USA, CalPERS' consultant, also is recommending:
- Instituting a copay of $100 daily for inpatient hospital care, with a $300 annual limit;
- Adopting a $15 copay for outpatient or ambulatory surgery;
- Increasing the copay from $10 to $15 for a physician's visit, excluding preventive care;
- Capping out-of-pocket payments at $1,500 for individuals and $3,000 for families;
- Raising copays for generic and brand-name medications;
- Boosting the copay by $25 to $75 for emergency department visits; and
- Adopting a $15 copay for urgent care for all HMO plans.
CalPERS also is considering a proposal by Blue Shield of California to cancel HMO coverage for 16,000 members who live in five rural counties. CalPERS last year rejected the plan, which Blue Shield estimates would save $35 million annually.
The insurer also wants to create small physician networks that would reduce premium costs for members. About 20%, or 77,000 of CalPERS' Blue Shield members, could enroll in the plan, which the insurer estimates could save an estimated $2 million to $17 million in health care costs next year (Chan, Sacramento Bee, 2/22).