Members were able to either choose from 46 facilities on the list that would result in them paying little to no out-of-pocket costs beyond deductible or co-insurance or pay the difference if they used another facility that charged more than $30,000.The result was that CalPERS health plan costs dropped significantly – by 19 percent from $35,408 to $28,695, per surgical-related admission. “This program was an effective tool in managing costs as we all know that current spending levels are not sustainable if we’re going to provide benefits that are affordable now and into the future,” said Ann Boynton, deputy executive officer for Benefit Programs Policy and Planning for the California Public Employees’ Retirement System, which has 356,543 PPO members in California served by WellPoint’s affiliated health plan. “We believe that innovative benefit design is an important component of controlling health care costs and increasing access to quality care,” said Ken Goulet, WellPoint executive vice president for Commercial and Specialty Business. “As we continue developing benefits that have a positive impact on cost and quality for employers and consumers, HealthCore’s research findings offer validation that we are not only making progress, we are actually moving the needle.” The analysis also found:
- Use of designated facilities increased by 21 percent by CalPERS members
- Member out-of-pocket costs remained relatively flat from 2011 to 2012
- Outcomes were either equivalent or better in the group using the designated facilities
- CalPERS members had significantly lower 30-day general infection rates than non-CalPERS members
- CalPERS members had significantly lower general complication rates in 30 days than non-CalPERS members
About WellPointAt WellPoint (NYSE: WLP), we believe there is an important connection between our members’ health and well-being—and the value we bring our customers and shareholders. So each day we work to improve the health of our members and their communities. And, we can make a real difference since we have nearly 36 million people in our affiliated health plans, and nearly 68 million people served through our subsidiaries. As an independent licensee of the Blue Cross and Blue Shield Association, WellPoint serves members as the Blue Cross licensee for California; and as the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as the Blue Cross Blue Shield licensee in 10 New York City metropolitan and surrounding counties and as the Blue Cross or Blue Cross Blue Shield licensee in selected upstate counties only), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. In a majority of these service areas, WellPoint’s plans do business as Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Georgia and Empire Blue Cross Blue Shield, or Empire Blue Cross (in the New York service areas). We also serve customers in several additional states through our Amerigroup subsidiary and in certain markets through our CareMore subsidiary. Our 1-800 CONTACTS, Inc. subsidiary offers customers online sales of contact lenses, eyeglasses and other ocular products. Additional information about WellPoint is available at www.wellpoint.com.