Managed Care

 

Kaiser-CalPERS Deal: Rate up, Oversight Too

MANAGED CARE July 1998. © MediMedia USA
State Initiatives

Kaiser-CalPERS Deal: Rate up, Oversight Too

MANAGED CARE July 1998. ©1998 Stezzi Communications

The nation's second-largest health care purchaser and the country's largest not-for-profit health plan have ended a two-month standoff over rate increases.

The California Public Employees' Retirement System and Kaiser Permanente agreed on a 10.75-percent rate hike in 1999 for premiums for current enrollees. Kaiser originally proposed a 12-percent boost — far higher than the average 5-percent increase CalPERS negotiated with nine other HMOs — prompting a CalPERS threat to freeze new enrollment into Kaiser plans.

Kaiser does not negotiate rates, but it did some horsetrading with CalPERS to get an increase both parties could accept. In exchange for the 10.75-percent hike, Kaiser gave CalPERS auditing authority to investigate the HMO's justification for future increases. In addition, Kaiser and CalPERS will hold quarterly meetings to monitor Kaiser's progress in solving the HMO's financial problems. The proposed 12-percent rate hike was a result of Kaiser's 1997 $270 million loss.

Meetings

4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015