New PBGH Plan to Offer Consumers Online Quality Care Information
As expected, the Pacific Business Group on Health, a San Francisco-based purchaser of insurance for 44 California employers, yesterday unveiled a new fixed account plan that it will offer to its membership as an alternative to managed care, the Wall Street Journal reports. The new plan, called Breakthrough, is the result of a two-year study conducted by PBGH that led to its partnership with the Minnesota-based Definity Health, which will administer the plan. According to the Journal, the new option is a "departure" for the not-for-profit group, which in the past has worked to improve health care "value and quality," but has never before "endorsed a commercial product" (Rundle, Wall Street Journal, 11/9). Breakthrough requires no copayments or referrals and offers consumers a wider selection of doctors and hospitals. Each employee receives a personal care account in which their employers deposit $1,000 to $2,000 per year. This money can be used for all health care needs other than preventive care, which is already fully covered by the plan. Unspent funds can be carried over to the next year, when employers will once again make a deposit. If an employee uses all the money in his or her account, the employee has to pay a deductible for additional health care for the remainder of the year (California Healthline, 11/8). Breakthrough will also provide "online health quality information that can be tailored to an individual participant" to make consumers "more aware" of health quality and costs so they can make "wiser choices," the Journal reports. For example, members with high blood pressure could receive emails about treatment options and research. According to PBGH president and CEO Peter Lee, Breakthrough will also include the employer group's quality information on hospitals and "certain medical procedures" and will eventually include "physician profiles" (Wall Street Journal, 11/9).