HomeMy WebLinkAboutMINUTES - 02141989 - 1.32 ........ _.. :_. . . ..
TO: BOARD OF SUPERVISORS 1-0304d
FROM: Harry D. Cisterman, Director of Personnel Contra
COSta
DATE: February 1 , 1989 County
SUBJECT: Pacific Peer Review Contract - 1st Choice Health Plan
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATION - -_
It is ordered that the Director of Personnel be authorized to nego-
tiate a contract with Racific Peer Review for the purpose of providing two addi-
tional cost containment programs for the County's 1st Choice Health Plan.
BACKGROUND:
Pacific Peer Review currently provides cost containment programs for
Utilization Review and Second Surgical Opinions. In a continuing effort to
provide effective cost control methods for the 1st Choice program, two addi-
tional cost control programs are available from Pacific Peer Review-Hospital
Bill Audit and Individual, Case Management. The Hospital Bill Audit Program aims
at identifying overpayments to hospitals .due to hospital billing errors for high
cost claims. The Individual Care Management Program assists in the direction,
coordination and use of alternative health services without compromising quality
of care. .
Average cost recoveries are anticipated to range from. 3-5% of the
total amount audited for the Hospital Bill Audit Program. Estimated savings for
the Individual Case Management Program is anticipated to range "from $3.00-$5.00
for every $1.00 spent on the program.
FISCAL IMPACT:
Costs will depend upon utilization. Overall , estimated savings from
these programs will not only pay for the program costs but assist in reducing
health care costs for the 1st Choice Health Plan'.
10:PPRCTRT
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CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR REC MENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION.OF BOARD ON F.5 i i i9.89APPROVED AS'RECOMMENDED X OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
Originating Department: Personnel Department -, Benefits Division FEB 14 1999
CC: County Administrator's office ATTESTED
County Counsel Phil Batchelor, Clerk of the Board of
Auditor-Controller Supervisors and County inistral