CalPERS Requests Suggestions For Improving Health Care Payment, Delivery Systems
The California Public Employees Retirement System has "formally" requested ideas to improve the "insurance and delivery process" from more than 100 medical groups, hospital systems, disease management firms and managed care companies, the San Francisco Business Times reports. CalPERS is hoping that considering new ways to deliver and pay for health care for its 1.1 million members will address a "number of disturbing health care trends," including double-digit managed care rate increases and HMO "pullout[s]" from rural areas. Allen Feezor, assistant executive officer for CalPERS, said, "Despite some success in health care purchasing in the last decade ... the industry still has not maximized the value it is able to produce. We are not convinced that our current HMO vendors are focusing their attention on the kinds of care, disease and chronic condition management our members need." He added, "We're not necessarily looking for the whole bicycle. Maybe a better handlebar or gear shift." CalPERS expected to receive responses to the request by last Friday. One possible outcome from the request could be direct contracting. Under such a system, CalPERS would contract directly with providers and "bypass" the managed care companies "in some cases." Glenn Smith of Watson Worldwide Benefits said, "The interest in (other modes of insuring, including direct contracting) is to find some other way to arrange for health-care benefits that are a little more cost-efficient" (Doherty/Robertson, San Francisco Business Times, 7/9).
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