Bainbridge council defeats employee health counseling proposal

Published 11:16 am Friday, September 21, 2012

Bainbridge City Council members unanimously passed the city’s new budget on Tuesday night, but were split on a proposed health care program for city employees.

City Manager Chris Hobby presented a proposed contract between the City of Bainbridge and Community Health Network, which offered “a scientifically-based program of services clinically proven to improve the health [of participants] and reduce the costs of health plan claims.”

The program would essentially have provided regular one-on-one counseling sessions for city employees identified as being at high risk to have health problems, with the goal of improving overall health and preventing costly insurance claims.

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However, the council defeated the proposal by a vote of 4-2. Council members Roslyn Palmer, Luther Conyers, Phil Long and Joe Sweet voted against the proposal, while council members Glennie Bench and Dean Burke voted for it.

Scott Forsyth, whose firm recently won a bid to continue providing the city’s health insurance policy, had told the Council on August 7 that health counseling programs were becoming more popular among large organizations as an attempt to keep health costs down.

During the past year, the city experienced $1.5 million in health insurance claims. About $900,000 of that amount was comprised of claims that exceeded $55,000, according to Forsyth. Fifteen employees had high enough total claims to trigger the policy’s “stop-loss” amount, meaning that additional claims were paid by the insurance company instead of the city, which has a partially self-insured plan.

“We’ve never hit our maximum aggregate [claims cost] until this year,” Hobby said.

According to Hobby, the idea of implementing a more comprehensive wellness program was originally introduced by Councilman Burke as a way of taking a preventative approach to health issues before they require treatment.

“[The program] encourages certain lifestyle changes or behavior modifications that lead to a healthier lifestyle,” Hobby said.

Forsyth previously told the council that in general about 50 percent of a large organization’s health costs are behavior-related.

“About 90 percent of insurance money is spent on treating sick people,” Forsyth said. “Only about four percent is spent on prevention.”

The proposed counseling program would not have replaced the city employees’ annual spring health fair—the city spends about $3,000 so that employees can have basic blood work done for free and receive a general health report. On average, about 50 percent of city employees participate in the health fair each year, according to Hobby.

“Every year that we’ve done the health fair, we’ve had employees who discovered that their blood pressure or blood sugar was off the charts and they had no idea that was the case,” Hobby said.

Community Health Network’s program would have done more extensive blood work, taken biometric measurements such as blood pressure and body fat indexes and had employees fill out a health risk questionnaire. Each participant would have received a personal health report and gone through at least one 30-minute counseling session to have their health risk profile explained to them, according to the proposal.

Employees with higher health risks would have been invited to weekly or monthly sessions during which counselors would help motivate them to make better health choices.

Although the city wouldn’t have required employees to participate, they would have faced a 17 percent increase in the health insurance contribution taken out of their paycheck—equal to the annual cost bump experienced on the insurance policy— if they didn’t at least go through the initial consultation.

Councilwoman Palmer voiced her concern about the program’s annual cost of about $65,000 per year, which she thought was too much if only a small percentage of employees participated. She wanted Hobby to poll all of the city’s employees about the proposed health management program and see whether they planned to take part. Palmer also suggested a cheaper alternative of inviting local health and fitness experts to make presentations to city employees.

“In my experience, changing high-risk behavior is very difficult, it involves lots of motivation and habit changes,” said Councilman Burke, who is an OB/GYN by profession. “Local people may have lots of expertise with health and fitness, but not with the type of counseling this program would provide.”

Councilwoman Bench said local health care providers and health/fitness facilities could still be utilized in tandem with the counseling program, which would create a detailed action plan for employees who were at higher risk.

All of the information would have been kept confidential between each employee and the Community Health Network, with only overall group-wide statistics being shared with city officials.

Hobby said that although CHN’s track record was that clients normally saved 10 percent on their overall health costs each year going forward, the counseling program was about more than just saving money.

“If [CHN] delivers on what they promise, this year alone we would expect to see about $167,000 in savings on our health costs,” Hobby said. “It’s also about early detection of risk. You may have people who are at risk for diabetes or heart disease. The goal would be to get people into programs that manage their conditions before they become chronic.”