The issue of whether Manatee County government should establish an on-site health and wellness center just for county employees and their families has been percolating for months. The medical community raises objections over fears community-based physicians would lose patients to the clinic. County administrators point out the clinic would make appropriate referrals and coordinate care. No specialty care would be provided. An on-site clinic would work best for workers lacking primary care physicians.
The county operates a self-funded health care plan, paying doctors for employee treatments with employees paying premiums much like private insurance. A clinic would reduce taxpayer expenses, the county maintains. A third party would operate the clinic in a public-private partnership. The medical community could compete for the contract once the county submits a request for proposals, should commissioners approve an on-site clinic. The debate continues.
The history of the county's employee health care provides a solid foundation for the clinic. Some 15 years ago, the county began providing on-site clinical services, beginning with a wellness professional and gradually adding staff and health programs. Then in 2006, Manatee became self-insured to eliminate exposure to rising premiums from private insurance companies.
The focus from the start has been wellness. By promoting healthier lifestyle choices and changing employee behavior, the county rewards those workers with cheaper premiums and copays. That monetary incentive has been working. The county first targeted diabetes, then smoking, then obesity, successfully improving outcomes and health.
County Administrator Ed Hunzeker told the Herald Editorial Board last month that the county has been reaping the benefits of wellness with lower costs over the past four years. Plus, with less sick time among employees, the county gets greater productivity, another plus.
An on-site clinic would advance the wellness model. Here again, the county would provide incentives for workers to use the clinic.
"The intention is not to take people away from established relationships," Kim Stroud, the county's employee health benefits division manager, told commissioners during a September workshop on the idea.
She told the Editorial Board in January that on-site clinics are common and yield "huge savings for taxpayers." A feasibility study conducted by Aon Hewitt found health care from an on-site clinic would be cheaper than in the community.
But these figures are most impressive. Since 2009, the cost of health care plans in Florida have soared by an average of 11.4 percent annually, but Manatee County has enjoyed annual decreases of 2.3 percent. Plus, the county has not increased premiums or cut benefits, unlike other plans.
Nearby counties, cities and school districts operate on-site clinics. This is a well-established, successful model among major employers, too.
There's no getting around the fact that there will be an impact on the medical community. The county employs 3,200 people. Their dependents put the total number of potential patients at 7,000. Inda Mowett, a doctor and representative of the Manatee County Medical Society, told commissioners at January's workshop that roughly 15 to 20 percent of the patients served by local doctors are county employees.
Commissioners must determine the priority here when this comes for a vote. Commissioner Vanessa Baugh focused on employees at that workshop, stating: "We have a responsibility to our employees to make sure they get the best possible care that we can afford to give them. ... I can see how it (a clinic) would be advantageous to our employees. We have to think of them first."
And taxpayers, too.
This is a sound proposal whose time has come. Commissioners should approve the plan.