CalPERS Compare frequently asked questions

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1 CalPERS Compare frequently asked questions Why is CalPERS launching CalPERS Compare? CalPERS is committed to helping its active and retired members receive highquality care at an affordable price. CalPERS Compare is consistent with that commitment. CalPERS believes that the CalPERS Compare tool will be of great value to its members. It provides comprehensive information on medical costs, provider quality, patient satisfaction scores, and location convenience, all of which will help give members added confidence in their health care decisions. CalPERS Compare is available through Anthem Blue Cross for all PERS Select, PERS Choice, and PERSCare plan members. The tool is powered by Castlight Health. What happens if we choose not to use CalPERS Compare? At CalPERS, we want to ensure that all members have the best health care resources available. As health care costs continue to rise, CalPERS is committed to helping its members and agencies save money and choose high-quality medical care. If your agency chooses not to participate, your employees will miss out on a resource that could have a positive impact on their lives. Is there a cost to members and the agency? CalPERS Compare is available to CalPERS members and their dependents, at no additional charge. There are no costs to you as an employer. If this program is meant to help our agency compare and control health care costs, will participants be able to see how much physicians and medical services cost?

2 Yes. CalPERS Compare displays estimated cost information for doctors and medical services that other CalPERS members have used within the past two years. This cost information is updated on a regular basis, and reflects data from medical claims that are submitted to health plans nationwide. Will all physicians who are currently in our PPOs be included in CalPERS Compare? Yes. In most cases, users can see the prices for all physicians in the Anthem Blue Cross Basic PPO plan. However, there are some times when limited data will be available. CalPERS Compare will generally display information for the most commonly used doctors and medical services. Also, because information is updated on a regular basis, the data becomes more valuable over time. Are we reducing our network of doctors by working with CalPERS Compare? If doctors don t want to release their prices, does CalPERS Compare drop these doctors from its service? No. CalPERS Compare does not impact your Anthem PPO network. CalPERS Compare is powered by a third-party application called Castlight that simply provides the information your employees need to make good health decisions. CalPERS Compare does not interfere with the rates that doctors charge. Can CalPERS Compare help our employees calculate the cost for a medical service after a Blue Cross PPO payment? Yes. CalPERS Compare calculates each of its user s actual out-of-pocket cost for specific medical services. It considers deductible status, physician, and facility before calculating the final cost. Your employees do not need to perform any calculations CalPERS Compare will do it all for them.

3 Can CalPERS Compare guarantee that our employees data will be private and secure? How about data for sensitive issues such as pregnancy, mental health, and certain types of illnesses? CalPERS Compare is powered by Castlight. Castlight takes user privacy very seriously. All user activities are private and secure at all times, and are never shared with employers. Castlight maintains the highest security standards and is required under federal HIPAA guidelines to keep its users data safe. The company is a member of TRUSTe, the leading authority for privacy standards on the web, and has also partnered with McAfee and VeriSign to ensure adherence to some of the strictest security standards in the industry. For more information on Castlight Health s privacy standards, please see the Castlight privacy policy. Most of our employees already have doctors. How will CalPERS Compare help them? Doctors often recommend specialists, lab tests, and other medical services without any idea of how much they actually cost. Your employees can use CalPERS Compare to research their recommendations, and compare the range of out-of-pocket costs. They can also use CalPERS Compare to search for services for family members. CalPERS Compare is an easy and helpful way for patients to understand their health plan and past care. How is CalPERS Compare different from other Internet-based services? CalPERS Compare is a unique service that provides personalized cost information. CalPERS Compare shows all users how much the out-of-pocket costs will be for medical services based on their individual health plans, the doctors in their preferred networks, and their deductible statuses. Also, CalPERS Compare

4 provides an overview of health plan benefits, tips for making smart health care decisions, and details about past claims. Where does CalPERS Compare cost information come from? CalPERS Compare provides estimated costs for the doctors and medical services that CalPERS members have visited within the past two years. This information is updated continuously as ongoing medical claims are submitted to the health plan. How much can our employees expect to save on health care costs? Your employees may be able to find much more affordable care with CalPERS Compare, which allows its users to see all their options for nearby in-network doctors. For example, a CalPERS Compare user who searches for a primary care doctor will usually find a price range for an office visit greater than $100. CalPERS Compare also provides information such as: where a doctor went to medical school, how long the doctor has been practicing, and how other patients have rated the doctor s level of care. CalPERS Compare allows you to see all of your options and choose the option that works best for you. Do doctors who have lower prices for office visits tend to have lower prices for all the services they perform? Yes. If a user chooses a doctor who charges less for an office visit, that user may be able to save significantly on future visits. For example, if Doctor A costs more than Doctor B for the same type of office visit, it s likely that Doctor A will also cost more than Doctor B for other types of procedures. Physician charges and reimbursement rates are not consistent for a variety of reasons, and do not necessarily correlate to the quality or the service delivered. A high price is not a reliable sign that a doctor provides better care, and that is

5 why we are providing you with tools that allow you to find high-quality doctors who charge below-average prices near you. Using CalPERS Compare to select a primary care doctor can result in cost savings both now and in the future. Where does CalPERS Compare quality data come from? CalPERS Compare is powered by Castlight. Castlight data about doctor quality comes from a wide range of public and private sources, including The Leapfrog Group, the U.S. Department of Health and Human Services, government reporting agencies, and consumer ratings resources. How often is CalPERS Compare data updated? CalPERS Compare is powered by Castlight. Castlight updates each user s deductible status after every visit, and updates past medical history and pricing data once a month. Note: Because users deductible statuses are updated more frequently than their past medical history, the deductible status will always reflect the most up-to date total of the user s overall spending history. It will also reflect the user s most recently processed medical claims. Users total spending (on the Your Plan page) is based on their latest monthly past medical history update, and may not reflect the most recently processed medical claims. What information can users see about their family members? And what information can family members see about our members? CalPERS Compare is powered by Castlight. Castlight follows all federal and state health care laws and statutes, including HIPAA. By default, Castlight primary account holders will see past medical care records for themselves and minor children. The primary account holder will only see limited billing information (as required by law) for a spouse or domestic partner and adult dependents.

6 However, spouses, domestic partners, and adult dependents can choose to change their profile settings to display complete past medical care records. Spouses and domestic partners will see only their information and the information of minor children. Primary account holders can choose to grant their spouses or domestic partners access to past medical care records by changing the account profile settings. Adult dependents can only see their own past medical care records.