PacifiCare Unveils Plans for Mental-Health Parity
UCI to Host Session on Health Plan ‘Report Cards’; Local IPA Contracts Sold
HEALTHCARE
by Vita Reed
Parity for mental healthcare coverage is the law in California, and some analysts believe it will soon become the law of the land.
In anticipation of that, PacifiCare Behavioral Health, a Laguna Hills-based subsidiary of PacifiCare Health Systems Inc., is launching a new set of plans intended to help employers comply.
California’s mental health parity law took effect in July 2000. It requires healthcare service plans to cover diagnosis and mentally necessary treatment for nine categories of severe mental illness at the same level as coverage for other illnesses. That would include outpatient treatment, inpatient hospitalization, partial hospitalization and prescription drugs, if the policy includes those for other illnesses.
At the time the law passed in the state, industry observers said it would raise healthcare premiums about 5%.
PacifiCare Behavioral Health’s new product is called Spectrum. It includes coverage for inpatient and outpatient mental health services, chemical dependency services including detoxification, and severe mental illness and serious emotional disturbances of children.
Other coverage areas include “work/life referrals” for covered employees, health management programs for smoking cessation, diabetes and depression and what PacifiCare calls “critical incident stress management” support for employers following traumatic workplace events. That package includes on-site critical incident stress debriefing and post-traumatic event counseling and resources.
Spectrum is designed for businesses with 250 or more employees. A PacifiCare Behavioral Health spokeswoman said that companies with fewer employees could buy the plan if they joined a purchasing coalition that pooled employers together to reach 250 or more workers. Spectrum so far is available only in California, PacifiCare’s largest market.
UCI Eyes ‘Report Cards’
Michael Chernew, a professor at the University of Michigan, plans to discuss “How Do Health Plan Report Cards Affect Managed Care Enrollment” at an April 18 presentation sponsored by the University of California, Irvine’s Graduate School of Management. Chernew’s talk is set to run from 7:30 a.m. to 9 a.m. at UCI’s University Club.
A summary of Chernew’s presentation points out that a cornerstone of the “managed competition” theory of health plans is providing consumers information about quality. According to the summary, employers and other groups have stepped up compiling and releasing information related to plan quality. The Pacific Business Group on Health, a San Francisco-based coalition of major employers, is well-known for doing such report cards, which are based on data from entities such as the Health Plan Employer Data and Information Set and the Consumer Assessment of Health Plans Survey.
Chernew’s presentation is set to examine how employees respond to report-card information. It will be based largely on analysis of health-plan report-card experience at General Motors Corp., which started giving such information to its employees in 1997.
Medical Group Sale
North American Medical Management California, Ontario, said it acquired the management contracts of seven independent practice associations from Medical Pathways Inc., Cerritos, for an undisclosed price. Noble AMA Select IPA, which has offices in Garden Grove and Santa Ana, and ProfessionalCare Medical Group, which includes offices in Santa Ana, Orange and Anaheim, were part of the deal.
With the deal, North American Medical Management California and its affiliates own or manage 21 independent practice associations throughout California, providing healthcare for about 517,000 members. It contracts with more than 1,000 primary-care and 2,000 specialist physicians. North American Medical Management California is an operating entity of PhyCor Inc., a Nashville, Tenn.-based company that has filed for bankruptcy. But officials of the California business said it is operated independently and hasn’t been affected by the parent’s reorganization effort.
Bits and Pieces:
Kirby Bosley of William M. Mercer Inc.’s Los Angeles office is scheduled to speak on Mercer’s 200l national survey of employer-sponsored health plans at the April 11 meeting of the Orange County Employee Benefits Council. The session runs from 7:30 a.m. to 9:30 a.m. at the Hyatt Regency, Irvine. Information: (714) 573-8605 Orange Coast Memorial Medical Center, Fountain Valley, introduced radio frequency ablation technology to heat and destroy malignant liver tumors. Cogent Healthcare Inc., Laguna Hills, said it introduced three new Internet courses for hospitalists, or physicians who work in hospitals Doctor’s Ambulance Service, Laguna Hills, installed automated external defibrillators on its fleet.
