State officials, searching for ways to control the ever-increasing health-care costs, have approved a one-year experiment in Charleston designed to control the costs of some of the state health plan’s most expensive patients.
The Public Employee Benefit Authority gave the plan preliminary approval Monday. The five-member Budget and Control Board must give the plan final approval in September before it would take effect in January.
The State Health Plan covers more than 446,000 state employees and their dependents, close to 10 percent of the state’s population, and the plan’s costs have been increasing at an alarming rate. Beginning in January, taxpayers will pay 6.8 percent more for state workers’ health insurance. While state employees will not pay more for their health insurance, they will pay more to use it, as co-pays increase by as much as 20 percent.
Meanwhile, officials estimate state retirees are owed $10.1 billion in future health-care costs, but the state has saved only about 5 percent of what it needs to cover those costs.
PEBA, the nine-member board created a year ago to oversee the state’s retirement systems and health plan, has been searching for ways to keep the state’s health-care costs low without sacrificing the quality of care. The board Monday approved a plan that would offer MUSC’s 18,000 employees and their family members access to a new kind of health plan: patient-centered medical homes.
Under the plan, patients would see not only doctors, but case managers designed to shepherd them through their various treatments. If they stay in the program, they are rewarded with lower deductibles and other incentives. But the premiums for employers and employees would not change, according to David Avant, PEBA’s interim executive director.
“Say you are a diabetic. You would get a phone call, making sure you are taking your medications,” said Art Bjontegard, PEBA’s board chairman. “They will be looking over their shoulder in an encouraging way to be making sure they are doing these right. The ultimate goal is for these people to live healthier lives and to live longer. If we can do that and save money, wow. Win, win.”
Patient-centered medical homes, as certified by the National Committee for Quality Assurance, are the latest trend in health-care innovation, state health officials say. South Carolina’s Medicaid program, with the help of a federal grant, is working to certify 18 pediatric practices as patient-centered medical homes, according to Tony Keck, director of the S.C. Department of Health and Human Services.
Private health plans in South Carolina are beginning to offer the plans as well, according to Jim Ritchie, executive director of the South C.C. Alliance of Health Plans.
“This will save money in the long run, that is the national thinking,” Ritchie said.
Bjontegard said this is the first of several pilot programs the PEBA board will consider in coming months. If any of the experiments prove successful, the board could roll them out to all state workers.
“About 80 percent of our costs come from 20 percent of our patients,” he said. “What we wanted to do is to approach those 20 percent of folks and find a better way to deliver them care so that their care is improved at reduced cost. If we can do those two pillars, I think we will have done both the patient and taxpayers and the broader humanity of our state a greater service.”
Reach Beam at (803) 386-7038.