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October 25, 2017

Clinic promises to cut county’s health care costs

Fauquier County government and schools hope to open the clinic by March. In the first year, it would serve about 2,000 employees.
We wanted the best resource for our employees, who are our greatest resource. That means making sure that they just get the attention they need.
— County Human Resources Director Janelle Downes
By .(JavaScript must be enabled to view this email address)
Staff Journalist
A new clinic-based approach for delivering health care services to Fauquier’s 2,000 county government and school employees eventually could save hundreds of thousands of dollars a year.

Fauquier’s board of supervisors this month hired Vermont-based Marathon Health LLC to establish a clinic to serve those workers.

“There are multiple benefits, both financial and workforce benefits” to the program, County Administrator Paul McCulla said. “Our employees receive health care in quick fashion, which means less time off for illness and (doctor) appointments.

“And, in the first year, potential costs should be totally offset by a reduction in health care costs.”

> See report at bottom of story

Under the Marathon plan, the county pays a one-time implementation fee of $179,975.

First-year medical expenses, including staffing, will total about $1 million, according to Marathon.

Over the first three years, clinic services would cost the county and school system $3.2 million, with a projected “savings” of $1 million, according to the health care consultant.

The clinic would help reduce and control health care insurance costs by:

• Addressing “low-intensity” medical problems for which employees often seek treatment at emergency rooms or urgent care centers — typically at higher costs.

“Low-intensity” problems include nausea and vomiting, headaches, viral infections and head injuries. During the three previous years, more than half the 2,413 visits to emergency rooms involved those kinds of conditions, according to the county. That treatment cost Fauquier $4.4 million.

• Eliminating unnecessary tests and procedures.

• Providing preventive care and encouraging good lifestyle habits.

• Detecting undiagnosed conditions and treating them before they get serious.

• Providing pre-employment and annual physicals.

• Providing prescriptions, flu shots and various routine tests and office procedures.

The clinic will allow employees to make more efficient use of their time, county human resources department Director Janelle Downes explained.

“I don’t have to wait in the doctor’s office,” Ms. Downes said. “I get swabbed right there and they send me back to work.”

“The whole design of the program is to offset health insurance costs and help pay for the clinic, whether it’s the rent (for office space), the doctor, the supplies.”

Based on research, that essentially has been the experience of Roanoke County, the City of Hampton school system, Plantation, Fla., and Lexington, Ky., according Ms. Downes.

Initially, only county government and school system employees and retirees covered under Fauquier’s insurance plan will be eligible to receive treatment at the clinic, Ms. Downes said.

But Fauquier in the second year hopes to extend that benefit to employee family members covered under the plan, she added.

Hired by Marathon, the clinic staff will include a doctor, nurse practitioner, two medical assistants and a support person.

Fauquier hopes the clinic will open by March 1, Ms. Downes said.

Employees can make appointments or receive treatment on a walk-in basis. Visits will require no co-payments.

While so far no schedule has been set, the clinic will operate during “regular business hours” Monday through Friday, Ms. Downes said.

Fauquier had hoped to convert space in the Warrenton Community Center along East Shirley Avenue but that would have been financially impractical, according to Mr. McCulla.

The county continues to negotiate with a Warrenton building owner to rent clinic space, Mr. McCulla said.

School Superintendent David Jeck knows-first hand that the clinic will help make life easier and healthier for workers and their families.

“The primary advantage is the convenience — having a resource like that right in town really helps out our folks in terms of being able to do something that ordinarily might take half a day . . . in half an hour, like getting a prescription filled,” Dr. Jeck said.

Before getting the Fauquier job in 2013, he served as superintendent of the Greene County school system, which had a similar clinic for its employees that worked well while it lasted.

But the grant that funded the program “ran out and we couldn’t afford to maintain it,” Dr. Jeck said.

He also views the clinic as potential tool to recruit and retain employees.

“It’s something we can add to the list of things we provide that might attract folks or keep them here longer.”

Fauquier maintains a “self-insurance” plan through Anthem, with the county paying for all claims. Employees cover a portion of their health care expenses. The amount varies, depending on the plan they use and the number of dependents.

In fiscal 2016, the county’s health insurance tab totaled $28.2 million. In 2011, it amounted to $20.3 million. During that six-year period, the county’s insurance bill has increased an average 8 percent annually.

Six companies submitted proposals to establish a health clinic for the county, Ms. Downes said.

A county selection committee chose Marathon because “we wanted the best resource for our employees, who are our greatest resource,” she said. “That means making sure that they just get the attention they need. The whole wellness thing that you hear about — they have a proven track record.”

A Marathon representative couldn’t be reached for comment.

Employee Health Clinic 2017 BOS Work Session 09.14.17 (1) by Fauquier Now on Scribd

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Jim Griffin · October 25, 2017 at 4:21 pm
I like this approach, self-insuring, even self-providing care for basic needs while insuring and out-sourcing the bigger less-basic needs.

More progressive even than single payer, this is single provider, much as can be found around the world (at least for basic needs, it relies upon the direct provision of care).

Wish the rest of us non-county employees could buy-in to the approach. Happy to pay a basic fee for clinic access alongside a high-deductible, lower-cost policy for non-clinic care, but it's not ACA compliant.
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