HomeMy WebLinkAboutMINUTES - 06061986 - 1.84 1 — 084 �
TO: BOARD OF SUPERVISORS
FROM: Harry D . Cisterman,' Director of Personnel C ltra
(Cps LQ
DATE: May 16 , 1989 coi 11I1
SUBJECT: Pacific Peer Review Contract for 1st Choice Health Plan
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
Recommendation:
Approve and authorize the Director of Personnel to execute the
Pacific Peer Review contract on behalf of the County and its special
districts for the County's self-funded health plan, 1st Choice. This
contract will provide two additional lst Choice cost containment programs -
Hospital Bill Audit and Individual Case Management. ,
Background:
The Board of Supervisors under Board Order dated February 14,
1989 approved Pacific Peer Review as the County contractor for providing two
additional 1st Choice cost containment programs - Hospital Bill Audit and
Individual Case Management. The Hospital Bill . Audit Program aims at
identifying overpayments to hospitals due to hospital billing error for high
cost claims. The Individual Case Management Program assists in the
direction, coordination and use of alternative health services without
compromising quality of care. This Board Order is necessary to execute this
contract with Pacific Peer Review.
Fiscal Impact:
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 are anticipated to range
from $3-$5 for every $1 spent on the program. 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.
CONTINUED ON ATTACHMENT: YES SIGNATURE,
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
S I TURE(S 1: ((��
ACTION OF BOARD ON MIN_619.89 v APPROVED AS RECOMMENDED p OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT; ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
originating dept : Personnel - Benefits Division JUN 6 1989
cc: County Administrator ATTESTED
County Counsel PHIL BATCHELOR, CLERK OF THE BOARD OF
Auditor-Controller SUPERVISORS AND COUNTY ADMINISTRATOR
L�,� 2X
M382/7-63 BY ,DEPUTY