Counties Implement Wellness Programs, Realize Taxpayer Savings
Ector County Judge Susan Redford described it as “the most successful program we’ve implemented in years, by far.”
Midland County Commissioner Randy Prude touted the dual benefits of significant taxpayer savings and a healthier county staff.
Joyce Dean, director of administrative services for Victoria County, explained it as “a very proactive approach to preventative health care.”
All three counties have set the stage for savings via a healthier staff with the implementation of employee wellness centers/clinics.
“I am very pleased with the usage of the Ector County Employee Wellness Center,” Redford said. Since the Center opened in September 2008, more than 700 employees and dependents have received wellness assessments.
“Through that process we have been able to assist employees in identifying numerous high-risk concerns and treat those concerns before they become catastrophic illnesses,” she continued. “In the first year, we estimate the cost savings to be just over $400,000 for the taxpayers of Ector County.”
Pat Patton, Ector County human resources director, said the self-insured county pays out about $5 million each year to cover the medical expenses of its employees and retirees. Patton predicted the county would save some $1.2 million in insurance costs during a three-year period by using the clinic instead of paying claims to private practice doctors.
According to Ector County Auditor David R. Austin, for the fiscal year ending September 2009 the county expended $370,000 for the Wellness Center. For fiscal year 2010, the county has budgeted $386,500.
“We were just so glad the commissioners court decided to do this,” said Patton, who joined several Ector County commissioners on a tour of a Galveston County wellness center prior to launching the Ector County Center.
“What really grabbed my attention and that of the commissioners was the report on projected savings on long-term diseases,” Patton said.
The county selected a building it already owned to house the Center, which occupies half of the space; the other half belongs to the county maintenance department.
Ector, Galveston, Midland and Victoria counties all use centers managed by CareHere, of Austin. The counties pay an administrative fee to CareHere based on the number of active employees and active retirees. Dependents are eligible to use the clinic, as well.
The general operating procedures are the same in each county; however, there are some variances. For example, Victoria County opted to hire their own staff including one nurse, one nurse practitioner certified in general family health and women’s wellness, and one clerical worker. In the remaining county clinics the medical professionals are contract employees through CareHere.
The centers/wellness clinics are used along with the counties’ health care plans. Employees and retirees are encouraged, though not required, to use the clinics.
“Even if they use the clinic services, it does not preclude them from going back out to a primary care physician,” said Betsy D’Acierno, director of operations for CareHere. Clinic services are free of charge to users, meaning there is no co-pay, no percentage pay, and no deductible.
The wellness clinics offer the following primary care/family practice services: health risk assessments, annual physicals, sports physicals and well woman exams. Clinic staff also provide acute care for colds, flu and respiratory infections. In addition, chronic conditions, such high blood pressure, high cholesterol, diabetes, and asthma can all be cared for and monitored by the medical staff. The centers also offer flu shots and other limited adult immunizations as ordered by the center providers, and conduct blood draws as needed. When further testing and treatment beyond the scope of the clinic are required, users enlist the benefits of their county health plan.
Victoria County opened the Employees’ Primary Health Care Clinic in September 2006. The clinic started at 16 hours a week and is now operational at 40 hours, and has logged 7,257 visits, Dean said.
“Had these visits occurred in the retail market, the cost to our plan would have been approximately $1,023,237,” Dean continued. “During that same period our cost to provide the clinic was $844,857.” The net saving just on office visits was approximately $178,380. Additional savings included $75,000 in lab work and $2,627,781 in early detection savings including diabetes, hypertension and cancer.
Prior to the opening of the clinic, gynecological and prostate exams were subject to a $1,000 deductible when using the Victoria County health care plan. Now, these exams are free, Dean said. In fact, from September 2006 to Jan. 30, 2010, the clinic has conducted 572 gynecologic exams.
“Women who were not going for their checkups before are using our clinic,” she said.
One of the most popular aspects of the centers is the health risk assessment, which includes a blood draw and 28-panel test culminating in a 30-page report written in laymen’s terms.
In its first-year analysis, Ector County realized the following early detections: 58 with higher-than-normal blood sugar, six with markers for prostate cancer, and 50 with markers for hypertension.
“We looked at the projected cost to treat those people,” said Patton, “which would have been approximately $1.25 million over their lifetimes.” With early detection, these treatment costs could decrease drastically.
“If we can educate people and help them discover that they have these situations and encourage them to manage them through diet and exercise, along with their doctors’ care, maybe we can head off some very expensive claims,” Patton said.
When health care costs go down, the budget health care requirements go down, meaning savings to the taxpayer, Redford stressed.
Another popular feature of the wellness centers is the limited wait time, Prude said. Prior to the opening of the Midland County Employee Clinic about a year ago, an employee likely would have taken a half-day off work, sat among other sick people in a crowded waiting room, and paid a co-pay and percentage of the final doctor’s bill. Clinic visits are scheduled in 20-minute increments with no payment following the visit.
“The beauty of our center is we don’t double-book,” Patton said. The Ector County Clinic is open 24 hours per week for patient care and two hours per week for health risk assessment blood draws. Blood draws are 10-minute appointments, and remaining appointments are scheduled in 20-minute time slots; physicals are booked as two appointments.
“Our employees love it because they can go in and go out and get back to work,” Patton said. Users can schedule visits via telephone or online.
“You can diagnose all of those conditions that cost people dearly,” Prude said. “In the long run we hope we can save the employee and the county significant cost.”
By Julie Anderson