PacifiCare to Offer Plans with Higher Copayments for Stays in Out-of-Network Hospitals
With spending on hospital services responsible for much of last year's 7.2% increase in health costs, many insurers, including Santa Ana, Calif.-based PacifiCare Health Systems Inc., are requiring patients to pay more for such care, Bloomberg News/Orange County Register reports (Snider, Bloomberg News/Orange County Register, 10/3). According to a study by the Center for Studying Health System Change, while drug costs and "higher utilization" fueled health cost increases prior to 2000, increased hospital costs accounted for 47% of overall health costs increases last year (California Healthline, 9/27). To handle the increase, employers are shifting costs to employees and "pressuring" insurers to cut hospital costs. In response, insurers are offering plans that require copayments for hospital visits. Under a new option, PacifiCare beneficiaries who receive treatment at out-of-network hospitals would have to pay $100, $250 or $400, depending on their employers' health plan. To "steer" patients into hospitals within the PacifiCare network, the insurer is offering employers discounts of 5% to 20% on care at those hospitals. Beneficiaries would not have to contribute copayments for care at preferred hospitals, or facilities with which the insurer has negotiated lower prices. PacifiCare spokesperson Ben Singer said, "We're willing to give consumers a choice, provided they're willing to pay a higher rate for it." PacifiCare expects companies that employ 170,000 of its 1.7 million members to enroll in the plans (Bloomberg News/Orange County Register, 10/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.