Board approves Best Doctors second-opinion service over objections to cost and scope

San Francisco — The Health Services Board voted to contract with Best Doctors to offer members expert, document-based second opinions for complex or unclear diagnoses. The decision passed by roll call, 4–2.

Aon Hewitt and Best Doctors described a process in which members or the plan may initiate a review, records are collected and a subject-matter expert produces a detailed, evidence-based report; Best Doctors said it would also coordinate follow-up calls with members and treating physicians. Pricing was presented as a range: a basic per-employee fee estimated at $1.00–$1.50 per month, with optional outreach and extended-family add-ons.

Commissioners pressed for clarity about face-to-face expectations and demonstrated clinical value. Best Doctors’ representative said the program typically gathers records and completes expert review within seven to ten days (with fast-track options) and cited internal metrics: "We changed our diagnosis about 37% of the time and we changed the treatment about 75% of the time." Supporters said a centralized expert review can help members who cannot navigate appeals and can prevent unnecessary procedures; skeptics raised concerns about cost, overlap with existing second-opinion options in certain plans and adverse selection if participation were optional.

The board approved the engagement and asked staff to finalize the precise covered population and per-employee rate for inclusion in the HSS rate cards. The increase will be an administrative line on rate cards and therefore will affect premiums; staff noted premium-sharing rules and MOUs determine member vs employer shares.