Your Benefit Board is having serious conversations about health care quality and costs, and how they will affect PEBB health plans in the future. They want you to join the discussion.

 

Here’s what they’re talking about:

Starting with this newsletter, the Board will be rolling out materials designed to bring you into this conversation (see all the materials at www.oregon.gov/das/pebb/healthinfo).

 

Learn more about making wise use of our health care dollars by putting quality first and what this means to you and the PEBB group as a whole. Then share your thoughts — with your family, co-workers, Benefit Board and other representatives.

Getting good quality health care can help you stay healthy and recover faster when you are sick. But how do you know whether the care you get is good quality care?

 

When you understand that quality of health care varies, it’s clear that you can’t take good quality care for granted.

 

Your health plan should help you find and use information about quality of care that can help you stay healthy and help you make good decisions about treatment when you get sick.

 

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.

 

 

The Board has decided to include the Standard Account in its self-insurance reserves going forward. The account had been used to pay premiums on $20,000 in basic employee life coverage. This coverage will end Dec. 31, 2010.

 

"Thanks to PEBB making Weight Watchers part of our benefits, I have successfully lost 88 lbs!  I have tried everything before, Atkins, fasting, liquid diets and nothing worked.  I am halfway to my goal weight now because of Weight Watchers!!"

—A PEBB Member

 

"The single best tool they use in Weight Watchers is counting and recording what you eat. Unfortunately the print in their books is tiny for me, and tracking became a chore when I couldn’t find my glasses.  I thought, "Oh I don’t have to record it anymore; I’ll keep track in my head."  Well, not only are my eyes poor because I’m older, my memory is about as good. This is still the best plan. I just may have to resort to making my own tracking book sized for someone over 30!"

—A PEBB Member

No one plans to have an alcohol or drug problem when they start drinking or using drugs. It becomes a problem when it causes physical, mental, social, legal or financial harm.

 

If you’ve decided, for whatever reason, that you want to stop drinking, there’s a world of help and support available.

 

If you’re a smoker, you know how hard it is to resist smoking in certain situations. Maybe for you, this hot cup of coffee just wouldn’t be the same without a cigarette.

 

When you join the Quit For Life® Program, we’ll help you identify the things that make you want to smoke, avoid them while you are quitting and then re-learn how to enjoy them again without wanting a cigarette. Sound impossible? We’ve helped more than 1 million tobacco users do it, we can help you too. Call or go online today and learn how to take back control over your triggers.