Evidence indicates some types of health care can be overused — without balancing risks, benefits, alternatives and costs.
Sleep studies and advanced imaging (MRI, CT and PET scans) are two examples.
Beginning next year, PEBB plans will require a $100 co-pay for these services. The co-pay adds a financial element to consider when you make decisions about your care.
The Board looked at a range of options around cost and quality for 2011 plans. They chose a co-pay to encourage members to discuss the risks, benefits, alternatives and costs of over-used services with their doctors.
The co-pay will not apply to the annual out-of-pocket maximum. The plans will have an exceptions process when advanced imaging is used to stage cancer treatment.
Look for details during Open Enrollment in October.