ER use drives up city budget

Heavy useof the emergency room by city employees or their dependents continues to drive up Augusta health care costs, Augusta leaders learned in a Friday work session.

 

According to a report, the number of visits to an ER for medical care was 837 last year, resulting in $946,196 in claims the city paid that do not include ambulance fees.

The number has been on the rise since 2014, despite the city’s change in 2012 to a self-insured health insurance plan intended to better manage claims.

Augusta had some $27 million in total health care claims, filed on behalf of 5,013 employees or dependents, last year and is trending toward the same or slightly less for 2017, city administrator Janice Allen Jackson said.

Other “cost drivers” for health insurance include low participation in preventative and chronic care programs and the mail order prescription program, which can cut employee costs by about a third, she said.

Jackson is proposing raising employee premiums by five percent per pay period, or 15 percent for workers who don’t use the city wellness clinic and sign a tobacco waiver.

The co-pay for an ER visit will go from $300 to $400 to discourage unnecessary visits.

About 62 percent of employees receive the wellness discount, and Jackson plans to expand the city wellness clinic in an effort to increase participation.

Expanding the clinic – adding a wellness coordinator, a second nurse practitioner, PSA screening, an after-hours nurse line and expanded hours – is expected to cost Augusta an additional $444,000, according to Jackson’s presentation. Increased co-pays are expected to save the city $436,000.

Several of the six commissioners who attended the workshop indicated they were pleased with the additional health insurance information as 2018 budget talks continue. The health insurance portion was held first to allow the commission to approve it ahead of open enrollment next month.

One unrelated budget addition Jackson presented Friday was an increase in funding for the Augusta Development Authority to cover hiring a development specialist to focus on underserved areas, such as south Augusta.

The $200,000 addition is up from $60,560 the city paid the authority in 2015 and 2016.

The commission has additional budget study sessions – on topics such as eliminating vacant positions and other ways to cut costs – scheduled for Wednesday and on Nov. 7 and Nov. 13.

Reach Susan McCord at (706) 823-3215 or susan.mccord@augustachronicle.com.

 

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