School, county health clinics a wise move

Some two weeks ago, the Manatee County School Board gave the district’s administrative staff permission to explore the advantages that a free walk-in clinic would yield — with enthusiasm from the majority of the board. Since cost savings could be pumped into classrooms, property taxpayers would get more value for their money. That should be the outcome should the district pursue this worthwhile venture.

Healthier employees is the primary goal, with cost savings trickling down. Sounds like a winning strategy all around.

Last year, Manatee County government’s proposal to establish a public-private partnership for the creation of an on-site health and wellness center received a lukewarm reception from some commissioners. A January meeting did not move the needle.

The county proposal is also designed to drive down health care costs. Manatee already does an exceptional job on that score with its outcome-based health management program, which supplements private physician care.

Both the district and county operate self-funded health care plans, which puts the total health-care bill on taxpayers. Under fully insured private health insurance plans, employers pay an insurer in advance to cover projected claims plus the company’s overhead and administrative costs. But in a self-funded plan, money is only paid out when claims occur. Should claims during a particular month come in lower than forecast, that money can be invested into a reserve, interest-bearing account. But in a traditional plan, those savings add to the bottom line of the insurer.

The Manatee County School District covers 4,800 employees and a total of 9,450 people in its health care plan. Manatee County government, including the offices of the sheriff, elections supervisor, county clerk and other constitutional officers, insures 3,200 employees and 7,000 overall with dependents.

Taxpayers foot the multimillion dollar cost of those self-insured plans, with employees paying various amounts in premiums. It behooves our elected officials and public service administrators to seek savings everywhere possible in this expensive employee benefit.

While tax dollars are a driving consideration, healthier employees is by far the greater goal. Both the district and the county proposals for clinics are designed to accomplish that goal. At a May meeting, the school board heard about the very positive experiences at some Florida districts that operate walk-in clinics. The extended hours, the lack of a co-pay and some free prescription drugs proved popular. The overall convenience stood out, too.

When Manatee County scrapped traditional health insurance and became self-insured in 2006, the YourChoice Health Plan was established. The program focused on wellness by promoting healthier lifestyle choices and changing employee behavior, rewarding those participating workers with cheaper premiums and lower co-pays. That has worked very well with less employee sick time and greater productivity on the job. By opening an on-site clinic, the county would advance this wellness model to a higher level, again incentivizing participation.

How well has the current county wellness program worked? Since 2009, the cost of health care plans in Florida has soared by an annual average of 11.4 percent. Manatee County enjoyed annual decreases of 2.3 percent — all while holding the line on premiums and maintaining benefits, unlike other plans.

The private-practice doctors worry about the loss of patients to publicly operated clinics. But the county disputes that because the clinic would not provide specialty care. Whether community-based physicians embrace these clinics remains to be seen.

The sterling track record of clinic success elsewhere in Florida — both in health care outcomes and tax savings — should convince the community that this is a wise course to follow.

This story was originally published June 10, 2016 at 1:17 PM with the headline "School, county health clinics a wise move."