Essex County tries to trim health-care costs

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June 19, 2008

Essex County looks at insurance costs, options

By LOHR McKINSTRY The Press Republican Thu Jun 19, 2008, 12:00 AM EDT

ELIZABETHTOWN -- Essex County saves $450,000 a year by running its own prescription-drug plan for employees.

The county is looking for other ways to save money on health-care insurance, and consultants Jeff Burnham and Mark Crawford of Burnham Financial of Lake Placid have suggestions.

The three main health-care plans offered by the county will probably increase 15 percent overall for 2009, Crawford said.

"When we're all said and done and we blend everything together it's probably going to be 15 percent on health costs."

The county has 293 workers enrolled in Community Blue, 164 in Empire Blue Cross and 115 in New York State Health Insurance Program. There are also 185 retirees in Blue Shield NENY PPO, which has Medicare as the primary payer.

A crisis developed when the Hudson Headwaters Health Network of community health centers looked like it wouldn't reach agreement with Community Blue, Crawford said.

"They (Hudson) were threatening not to take the plan. That was an issue we had to work through."

Community Blue and Hudson Headwaters finally settled earlier this year.

Offering the more-affordable MVP Health Care insurance in the future might reduce some costs. Crawford said MVP has about 80 percent of the county's physicians signed up and may be the next plan to be recommended to county workers.

When the county self-insured its prescription plan, it got CVC Caremark to administer it. That allowed prescription rebates from pharmaceutical companies of $56,000 annually, plus a Medicare subsidy of $150,000.

"The savings on this thing are tremendous. About $450,000 is what we calculated," Crawford said. "It's well worth it (self-insuring)."

The drug plan has $10 to $35 co-pays and allows subscribers to get a 90-day supply of meds by mail-order.

The mail-order aspect worries Supervisor Randy Douglas (D-Jay), though.

He said three years ago Mountain Lake Services, then called Essex County ARC, went to an outside provider for client prescriptions and the county opposed it.

"I have a problem with mail-order prescriptions. It's driving our local pharmacies out of our local townships."

Employees like mail-order prescriptions for the savings, Crawford said.

"It's a tough situation. We offer it (mail-order) as an incentive. Employees are looking for any ways to cut costs that they can."

The county gets 28 percent off wholesale prices with mail-order, County Personnel Officer Daniel Palmer said. "It's such a huge amount of money."

Cost containment has been one of their chief goals for the county, Burnham said.

He said annual buy-outs of $3,000 for those who don't take insurance, NYSHIP, HMOs, prescription rebates and low-cost incentives are all offered to reduce the county's costs.

lmckinstry@pressrepublican.com