New Health Plan Cost Strategies for the City of Fort Worth. TMHRA Annual Forum May 2, 2018
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1 New Health Plan Cost Strategies for the City of Fort Worth TMHRA Annual Forum May 2, 2018
2 Finding the best care for our members Better monitoring our employees health in order to reduce emergency room visits and inpatient days Finding physicians that take personal responsibility for the care of their patients Improving the health of our members Guiding Principles Best Care High Quality Physicians Reduced Emergency Room Visits Better Wellness Sustainable Health Plan Maintaining a sustainable health plan 2
3 Feb-14 Apr-14 Jun-14 Aug-14 Oct-14 Dec-14 Feb-15 Apr-15 Jun-15 Aug-15 Oct-15 Dec-15 Feb-16 Apr-16 Jun-16 Aug-16 Oct-16 Dec-16 Feb-17 Apr-17 Jun-17 Aug-17 Oct-17 Dec-17 Health Plan Performance Medical Claims 8.5% trend = 50% plus increase in over six years Prior to 2015 no plan design changes since 2005 $26M+ over budget for 2016 and 2017 $1,100 $1,000 $900 $800 $700 Look-Back Rolling 12 Medical Claims 8.5% $ Predominant health provider system priced 20% above market $600 $500 Actual Regressed 3
4 Transition of Non-Medicare Retirees Removal of highcost/high trend group from city s self-insured plan $4.25M $417k $3.8M 2017 claim cost estimated at nearly $4.25M 262 retirees and/or spouses over the age of 65, not on city s Medicare Advantage Plan Original estimated cost to shift retirees to Medicare Advantage $2.57M 109 retirees were eligible for Medicare Actual cost - $417K New estimated savings - $3.8M+ Better benefit level than actives 95% paid, $1000 maximum out-of-pocket, drug co-pays 4
5 2018 Proposed Plans Health Center Plan Free primary physician care Provides copays for specialists and prescription drugs Maintains lower deductibles Pediatrics, obstetrics and mental health services continue with network physicians outside of health centers Consumer Choice Plan High-deductible Health Savings Account (HSA) available to allow people to save for health costs on a pre-tax basis Members will be able to use the health centers at a discounted rate All preventive care, including mammograms and colonoscopies, are free to members on both the Health Center Plan and the Consumer Choice Plan 5
6 Southwestern Health Resources Partnership Savings Features Health Center Unit Cost Concession Utilization Management Savings $2 3M $3M $2-4M DEDICATED health centers supplemented by satellite clinics Able to rapidly grow access to City Members at all SWHR primary care clinics and CVS clinics (not free to members) Meet metrics of same/next day sick visits, 5-minute wait times, patient satisfaction, etc. 3% escalator per year Texas health branded hospitals, Ambulatory Surgery Centers and radiology centers Will make THR a low cost referral destination for City of Fort Worth Integrated population health management featuring care management, disease management, navigation an analytics Range based on 50% 100% clinic plan intake Guaranteed savings in excess of utilization saving will be paid to City of Fort Worth at the end of plan year (verifiable through UHC) 6
7 Introduction of EMPLOYEE HEALTH CENTERS established through Texas Health Resources (THR) All services at the health centers and satellite locations are FREE Fixed cost to the health plan Tiered network with specialists co-pays Control quality of care No upfront costs to build Health Center Plan Convert PPO to Health Center Plan: Propose three health centers supported by five satellite locations in the North Texas area All members seen same or next day for sick appointments Staffed with quality doctors, physician assistants and nurse practitioners No mandatory referrals required Physician choice maintained with tiered copays within UHC network 7
8 Health Center Utilization Total visits January March Primary Health Centers: 2,144 Satellite Locations: 526 Total: 2,670 52% of available appointments have been filled 172 of 175 specialist referrals went to premium providers New diabetes program diabetics on our plan Phase I launch April 2018 Provides free insulin and supplies Testosterone program under development May or June rollout 6048 Lake Worth Blvd. Fort Worth, TX South Freeway, Suite 208 Burleson, TX South Main, Suite XXX Fort Worth, TX
9 Pharmacy Benefit Plan Changed Pharmacy Benefit Manager (PBM) October 2017 Part of a purchasing consortium for better pricing of drugs Estimated savings $3.8M in first year Assumed 10.6% trend 2018 Health Center Plan Design Changes Deductible increased from $50 to $100 per member Introduction of 20% coinsurance with min/max for each tier Generic - $10/$30, Preferred $30/$50, Non-Preferred $50/$75 9
10 Generic utilization Pharmacy Benefit Plan Envision 79% OptumRx 4 th Quarter % OptumRx as of February % Generic efficiency rate* is 99% The other 1% are paying the cost differential Claims Envision vs OptumRx Envision - $8,306,892, OptumRx - $7,566,384 Rebates from OptumRx - $862,010 Total savings for 4 th quarter - $1,572,518 *Generic efficiency rate is a measurement of the total number of prescriptions filled as a generic for products with a direct generic substitute 10
11 Thank You Brian R. Dickerson Human Resources Director City of Fort Worth
City of Fort Worth Health Plan Update. Council Presentation September 12, 2017 Brian R. Dickerson Director of Human Resources
City of Fort Worth Health Plan Update Council Presentation September 12, 2017 Brian R. Dickerson Director of Human Resources 2018 Proposed Plans Health Center Plan Free primary physician care Provides
City of Fort Worth Health Plan Update. February 21, 2017 Brian R. Dickerson Director of Human Resources
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Benefit Overview Welcome! HealthEZ is proud to serve as your benefits administrator. We help companies all over the US provide custom, personalized benefits to their employees. We re here to make your
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.preferredhealthchoices.com or by calling 1-563-584-4783
Coverage for: All Coverage Tiers Plan Type: POS. 1 of 9
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.paramounthealthcare.com or by calling 1-800-462-3589.
Important Questions Answers Why this Matters: Network: $3,500 Individual $7,000 Family Non-Network: $10,000 Individual $20,000 Family
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.inhealthohio.org or by calling 1-800-580-8502. Important
Important Questions Answers Why this Matters: What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.denverhealthmedicalplan.org or by calling 1-800-700-8140.
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-800-421-1880. Important Questions
Tier 1: $0/$0 Tier 2: $500/$1,500 Tier 3:$1,000/$3,000 Does not apply to preventive care. What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by contacting benefits@northside.com or by calling 1-404-851-8393.