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• • <br />Proposed Changes: <br />James Benefits encourages the City to include a hospice care benefit <br />as an alternative to inpatient hospital care for the terminally ill. <br />This should be provided as an alternative to the initial hospital <br />admission and as an alternative to continued hospital care if <br />hospital confinement is initially required. The benefit should <br />require no out-of-pocket copayment. In addition, the City should <br />consider a limit for this financial incentive to be 60 days. (Note: <br />In December 1982 a Washington, D.C. research group estimated the <br />average length of hospice care to be 50 days.) Any hospice care <br />exceeding 60 days should be paid at the usual 80% of eligible <br />expenses. <br />Estimated Net Savings: <br /> <br />James Benefits is unable to estimate the percent of <br />that the City could save with the hospice care <br />above. This estimate is not available because <br />national data indicating the incidence of hospice <br />individuals per year. As such statistics become a <br />Benefits underwriter can project net savings for <br />benefits. <br />total paid claims <br />benefit proposed <br />of insufficient <br />care per 1,000 <br />vailable, a James <br />a hospice care <br /> <br /> <br /> <br /> <br /> <br />C. 24 Hour Birthing Alternative <br />Inhospital maternity care represented a significant portion of the <br />health care service provided to the City's employees and their <br />families. Current health care competition enables employees and <br />their families to choose from at least two types of birthing alterna- <br />ti ves . <br />In addition to licensed free-standing birthing centers which provide <br />maternity care that averages 12-18 hours length of stay, hospitals <br />are competing with these birthing centers by offering 24-48 hour flat <br />maternity programs. Many such programs also include a rebate to the <br />patient when the length of stay does not exceed 24 hours (after <br />delivery occurs). <br />' Proposed Changes: <br />' James Benefits suggests that the City provide a 24 hour birthing <br />alternative to its employees and their covered spouses. This benefit <br />should include both 24 hour maternity care that occurs in a hospital <br />or in a licensed free-standing birthing center. As an incentive for <br />' this cost effective benefit, eligible expenses should be paid at <br />100% and these expenses should not be subject to the individual <br />deductible. <br /> <br />1 ~~ eE~~ <br />