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California's Colonoscopy Pricing System Cuts Cost, Not Safety


In 2012, the California Public Employees' Retirement System (CalPERS) implemented a new pricing system for colonoscopies in order to make the procedure more affordable for patients and ease its burden on the state's health care system as a whole. A report featured in the most recent issue of JAMA Internal Medicine found that this program resulted in savings of up to $7 million for the state.

The new cost model, called reference pricing, essentially states that CalPERS will cover the full cost of colonoscopy for its patients if they agree to undergo the procedure at a lower-priced facility, such as an ambulatory surgery center rather than a hospital-based outpatient location.

The system is designed to counter the unpredictable, but generally rising cost of screening colonoscopies. By encouraging participation at lower-cost facilities, CalPERS can offer full coverage for colonoscopy at no additional cost or co-pay for the patient.

An important factor to note is that, although the colonoscopies are performed at lower-cost facilities, the results of the study showed no reduction in the safety of the procedures since the initiative began. This is significant, as patients selecting lower-cost centers require assurances that they are receiving high-quality care.

California's iniative represents an exciting step toward reducing the cost burden of colonoscopy within the health care landscape.

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Topics: Colon Cancer News