Tiered Hospital Plans Raise Concerns from Providers, Patient Advocacy Groups
The Sacramento Bee today examines the trend of tiered hospital plans, which are raising concerns from health care providers and patient advocacy groups in the state. Under the plans, health insurers require members who receive care at more expensive hospitals to pay additional copayments of at least $100. Health insurers say that the plans can save employers 5% to 20% on the cost of health insurance premiums. "The point of this is to let consumers know which facilities are more expensive. It's connecting consumers to the real cost of care and letting them make a choice," according to Tom Epstein, a spokesperson for Blue Shield of California, which launched a tiered hospital plan on April 1. PacifiCare of California announced a similar plan last month. Opponents of the plans say that they "add unwanted confusion" for some patients and could affect access to care. Nabil Musallam of the University of California-Davis Medical Center said that the plans may prompt patients to make treatment decisions based on cost rather than on quality of care. They add that the plans could make some "life-saving" treatments unaffordable for low-income patients. According to Jill Yegian, a researcher at the California HealthCare Foundation, "one set of losers [under tiered plans] will be people who are heavy utilizers [of hospital services] who are chronically ill and already have the most costs" (Rapaport, Sacramento Bee, 4/25).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.