Mr. Bohlke examines how the California Public Employees Retirement System incentivized healthcare consumers to choose lower cost settings for common surgical procedures. CalPERS analyzed average costs for the procedures and capped what insurance would cover. Here are three key thoughts from Mr. Bohlke’s blog post.
1. “For too long the prevailing conventional wisdom among healthcare policy experts was that average consumers lacked the sophistication necessary to make smart choices, and instead, almost automatically defaulted to high-cost providers presuming that higher prices were equated with higher quality. Essentially, what CalPERS did was challenge that conventional wisdom, betting instead that healthcare consumers were more capable than the credit they had been given.”
2. “ASCs offer certain efficiencies that hospital outpatient departments cannot, and can often charge significantly less for the same procedures while still meeting and exceeding a wide range of rigorous state and federal regulatory standards.”
3. “Until recently, many consumers have been slow to use price data as part of their choice of providers, mostly because they have lacked a financial incentive to do so. What the CalPERS-funded research found, however, is that new benefit designs and transparency tools show considerable promise for an increasingly consumer-driven healthcare system.”
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