Information, so they know which providers are at or below the Reference Price and you need to arm them with the quality information, how often are these providers performing these procedures . What is their volume, what are their outcomes . It would be really unfair to implement a Reference Price if you arent going to arm them with that kind of information. That goes into the next one, which is consumer education. I think there will be case study examples of how informing your employee population and educating consumers about the price and the quality and that and the correlation between the two will be really very important because you dont want consumers to get into a got you situation where they didnt know that someone was above the Reference Price and now they have a pretty extreme financial out of pocket liability. The last one is adequate networks, it might not be an appropriate term here, because usually these are providers within an established network. So i use the term networ
Imagine from the title of its organization and this includes more than 3000 Public Schools and agencies and state employers covering more than a million and a half and david is here to tell us about the calpers reference pricing and its impact on health care and the cost as andrea has said that he might been promised that he might. We thank you for coming. Thank you, ed. Okay. Im going to talk about this program for hip replacement and it provides Health Benefits for 1. 1 million members statewide and that includes active and retired state employees including school districts. About a third of those end up in the preferred provider organizations with Anthem Blue Cross of california and we spent about 7. 75 billion and the impetus for referencebased pricing was also a variety of studies in this includes for Knee Replacements and we looked at cost drivers and it turned out that the osteoarthritis is one of the drivers in about a third of those costs come from hip or Knee Replacements. In
Sometimes a thousand dollars a month. I mean, you know, its a wide range. Some people will get subsidies and support and pay less. But theres this group in the middle who make just enough, they get no subsidy, and the price of their premiums for their plans is going up dramatically. But moreover, and this is just what after 36 meetings in my own district their deductibles, their deductibles, they fear, are at a level where unless you have a Catastrophic Health event in your family, you really dont have Health Insurance because youre paying upwards of 12, 15,000 where it was 2 or 3,000. And so they may go without, because you have a guarantee issue. So you can always go to the emergency room, right . The penalties are not more than the premiums. I think this is the chaos im talking about out there on the ground in communities all across america. A quick follow up . Sure, of course. Has there been time to actually figure out as this legislation has been going on which is the worst case .
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