Avoid HMOs, Pension Fund Told

A key task force advising the California State Teachers Retirement System on Monday recommended that the pension fund bypass established managed-care plans in favor of direct contracts with doctors and hospitals when providing health care for its 500,000 active and retired members.

The task force’s recommendation, which is expected to encounter resistance from health maintenance organizations and some political players in Sacramento, will be presented to the pension fund’s health benefits committee Jan. 6. If the committee accepts the proposal, it will go to the fund’s board for approval and a pilot program could begin soon after.

“It’s good news for California patients,” said state Controller Kathleen Connell, who sits on the retirement system board.

During a daylong meeting in Westwood, the task force heard from advocates of direct contracting and held a videoconference with a Minneapolis physician who helped pioneer a program for several large businesses in Minnesota.

Task force members asked a number of pointed questions about the proposal, which would require an enormous infrastructure of doctors, hospitals and oversight organizations in order to work statewide.

Others argued that it would take too long to set up, and might leave out retirees who are in need of immediate health insurance.

To satisfy those questions, the task force voted to recommend that additional measures be taken to provide health care in the short term for retired teachers, about 21,000 of whom have no coverage.