County department leaders meet to discuss health care issues, alternatives

  • By Dave Mast
  • May 23, 2010
  • 454
                        
Rising health care expenditures have forced the Holmes County commissioners and the county’s governmental department heads to take a closer look at how the county is creating its health care plan, and how one possible option may be to simply lower the number of claims through the use of a wellness program. Close to 20 department leaders and three county commissioners met with Craig Miller, director of human services, of Pomerene Hospital, and area insurance company representatives on Monday, May 17, at the Old Jail board room to discuss curbing rising health care costs and the possibility of creating a wellness plan for county employees. In a Feb. 4 meeting with insurance agents Mike McDowell and Mike Sommers, Amanda Webb, director of clinical services at Aultman Hospital, and Miller, the commissioners learned how Pomerene Hospital is reducing its claims while combating soaring health insurance costs. For some time now, the county has worked at curbing the costs of health care with little or no success. According to Commissioner Joe Miller, with the way health costs are soaring, the county must get creative, and the Pomerene plan is one such possibility. “What we are trying to do is tweak this thing so that we can make some progress, and so far we haven’t been too successful,” said Miller to the directors in attendance. “What we want now is to present this kind of an idea and have you take it back to your departments and discuss it. We want your input as to what you think of the ideas being presented. If we do this right, we could really see some nice savings.” Coming up with a health care plan that is both cost effective and good for everyone is no easy task, but Pomerene has experienced success with its model. Miller shared about steps the hospital has taken to manage its claims and health insurance costs. The initial move was to take on a wellness plan, while the second was a more controversial method of creating incentives and penalties in how their employees are paying into the health care plan, which included the prerequisite that any hospital employee’s spouse whose employer has a health plan must be taken off the hospital’s, and the spouse must go on their employer’s plan. Children may remain on the hospital’s plan, and they have created a hardship clause for certain situations. “We’ve run into cases where people were paying their employees not to be on their plan,” said Miller. “Any of our employees’ children can still be on our plan, but if their spouse’s employer has a plan available, they must use it. Every employer needs to step up and take care of their own.” The second adjustment in their health plan zeroed in on tobacco users. If employees use tobacco products of any kind, they are now paying an additional $20 per paycheck toward health insurance costs. Miller said it is an idea which is much like at-risk drivers paying more for auto insurance. Miller said that the majority of the savings the hospital has seen take place has been because of the change in spousal insurance. He said the savings created by the nicotine changes has been negligible. Miller told the department leaders about the savings being created by the various programs, and how they have benefitted the hospital’s overall health care bottom line. “The tobacco surcharge was almost a non-issue,” said Miller. “The biggest issues we faced came from employees concerned about having to move their spouse off of our health care plan if their company has health insurance. We experienced almost no negative feedback on the nicotine issue. We had met with our department heads after a year to discuss the results, and we were a little unprepared for the response on the spousal issue.” While the health care plan issues may be more volatile, what has been a smashing success has been the wellness program. The Pomerene wellness program offers incentives to those who choose to pursue a healthier lifestyle. Pomerene has joined Aultman to create a plan in which wellness coaches from Aultman will do testing and screening, create appropriate, individualized wellness plans and reward those who meet all of the necessary requirements. Every employee who decides to try to meet the wellness challenges will meet with their wellness coach quarterly. The coach will document all of the meetings, and employees must turn in any documentation of required meetings and appointments. All of the information is run through Aultcare, and Miller said that while many employees were concerned that the hospital would be looking over their shoulders constantly or would have access to private information, Aultman has a scorecard which keeps track of all of the wellness information, and Pomerene has no inkling of the activity, other than to know the progress each employee is making. Those reaching their goals receive $100, but the real incentive of the program is simply to have employees feeling better, and healthier, thus becoming more productive at work. McDowell, who was also in attendance at this meeting, said that wellness programs are designed to create long-term solutions. “What these types of programs excel at is setting the stage for long-term changes in people’s behavior which will not only benefit them, but will in turn benefit the company,” said McDowell. “These types of programs can pay huge dividends down the road.” As the program is set up now, Pomerene pays Aultman for all of the laboratory and nicotine test work, and Aultman keeps all of the individual records, supplying Pomerene with a comprehensive list of results only. This is so that the employees don’t feel threatened by the company, and the process is less invasive. McDowell said that there are a number of companies and groups moving to this kind of wellness plan, and from the results he has seen, the successful change in the wellness of different groups has sparked vast improvements in company-wide health. Miller said they weren’t there to shove the wellness program or the health care options down anyone’s throats, but rather the meeting was designed to be a starting place for possible solutions. “Ultimately, people should be responsible for their behavior, and if a person is going to enter into a high-risk situation, that is their decision,” said Miller. “We need to do something to change that, because our costs are getting out of control.” Last year, Holmes County paid $12.8 million in health care insurance, while $15.5 million was paid out in claims. The plan now is for the county department leaders to talk to their employees, and bring back results to a meeting down the road.


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