The California Public Employees’ Retirement System (CalPERS) Board of Administration has approved a pilot program designed to improve healthcare quality, enhance service and reduce costs for its members in Sacramento, Placer and El Dorado counties.
CalPERS has partnered with Blue Shield of California, Catholic Healthcare West, a not-for-profit hospital provider and system based in San Francisco, and the Hill Physicians Medical Group, a San Ramon, Calif.-based HMO healthcare network, to implement the pilot starting in January 2010.
The program will create an integrated healthcare model that aligns incentives among the health plan, hospital system and medical group. Members who choose to participate could receive enhanced services centered on disease management, prescription drugs and palliative care and pay a lower healthcare premium.
“We are continuously looking for innovative strategies to improve quality and service, and reduce costs for our members,” said Priya Mathur, chairman of CalPERS' health benefits committee. “We are pleased that our health partners are moving in the direction of pay-for-performance and evidence-based care, whereby doctors and hospitals are paid not for each service provided, but for the improved health outcomes for our members.”
Blue Shield officials anticipate the 12-month pilot will succeed in keeping the 2010 total cost of healthcare trend flat (or negative) as compared to the 2009 projected cost of healthcare in the targeted three-county region. Upon conclusion of the pilot, CalPERS, Blue Shield, CHW and Hill Physicians will review the results and make a recommendation on expanding the program to additional counties.
“This is right in line with our strategic vision to be a leader in providing best-in-class, quality and sustainable health benefit options for our members and employers,” said Rob Feckner, CalPERS' board president. “In the short term, we’re aiming to reduce our cost and improve delivery of healthcare in the Sacramento region. If successful, we hope to positively impact health outcomes and costs for more of our members over the long term.”