News Briefs
News Briefs
Pension funds work toward direct contracting
Californians are searching for new ways to provide health care — and may do away with HMOs in the process. Two pension funds that together represent 1.5 million people, the California Public Employees Retirement System (CalPERS) and the California State Teachers Retirement System (CalSTRS), may provide an answer.
CalPERS is considering eliminating its HMO contracts for more than a million members in favor of contracting directly with physicians and hospitals for its patients. In December, a CalSTRS task force also recommended direct contracting. Proponents of both arrangements say that by eliminating HMOs’ share of about one-fifth of the premium dollar, direct contracting could decrease premiums and may even increase reimbursements for doctors and hospitals. A direct contracting system has been tried on a large scale only in a few places, notably Minnesota. Opponents warn it could bring new administrative headaches.
Customers will have more clout
Customer service will be an important factor surrounding success in managed care of the future, according to Stewart W. Hall, president of Boston-based S.W. Hall & Associates, at a recent conference in Nashville, TN, sponsored by the American Association of Health Plans. "When your costs, networks, quality indicators, and benefit packages become more like your competition’s, the only way for your organization to stand out will be with service," he said.
Health care consumers may not always understand quality, but they do understand service. While customer service requires a minimal amount of investment, it can help an organization with accreditation and compliance issues. And good customer service can significantly boost an organization’s bottom line by helping decrease disenrollment rates. In the past, he said, customer service was viewed as the "fix- it department" now it is more of a "member advocate" department.
For more information, contact Stewart W. Hall, S.W. Hall & Associates, Boston. Telephone: (617) 934-9454. World Wide Web: www.swhall.com.
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