Ten years ago, Charlotte County started paying for its own health care system.
“Costs were just going through the roof,” recalls the county’s Budget Director Gordon Burger.
Today, even the insurance company they split off from, Cigna, is impressed by what the county achieved, Burger told the Sun Wednesday. Health costs started leveling off and within the last four years have remained flat.
“Find me another program that has kept health costs flat,” he said.
He told the story to county commissioners Tuesday. In a cash analysis, savings are $15 million for the county and another $5 million for the employees since 2009, Gordon said.
The real savings may be much higher, however, Burger said. Comparing health insurance cost increases during that time for the rest of the county, Charlotte County would have spent about $80 million more. And if you compare to Florida’s health care increases, which are higher than the nation’s, that number reaches $100 million in savings to Charlotte County taxpayers.
“That’s the slide that attracted my attention most,” said Commissioner Christopher Constance, a medical doctor.
Locals sometimes grumble when they hear about county employees’ health insurance, Gordon acknowledged in the Sun interview. County employees have their own clinic. They used to have no deductible (an amount they have to cover before the plan starts paying). Now, the county pays their deductible if they reach certain health milestones by losing weight. Their deductible shrinks just by getting an annual blood test. They don’t wait too long for appointments. They don’t get rushed through appointments, Burger said.
“Yes, we have a great plan, and we’re paying for it at Volkswagen prices,” he said.
Charlotte County’s experience should be a message to all health plans, Burger said. That message is that employers or health plan managers should invest in employee health to achieve long term savings.
The county began its adventure in health care back in 2009 when it decided to open a small clinic with a part-time physician and a full-time phlebotomist to draw blood. Next, the county decided to self-insure, but leave Cigna in charge of administering claims. The county pays a reinsurance company in case of extremely large health claims.
That clinic expanded. The county now contracts with The Crown Group to provide physicians and a pharmacy for a clinic, the first on Loveland Boulevard. After the sheriff’s office staff joined, the county opened another clinic in Punta Gorda on Taylor Street.
Employees are not required to use the clinic, but the cost savings are great. Now, 95 percent of employees participate.
Just running your own clinic and pharmacy is not enough, however. The county began investing in health improvement, taking advantage of anonymous data on chronic conditions.
To show improvements, Burger told commissioners that between 2014 and 2019, the percentage of employees with no chronic health conditions increased from 37.6 to 45.3 percent. The proportion of employees with, for example, hypertension or high blood pressure, dropped steadily from 25 percent in 2014 to 19 percent in 2018.
And that’s not due to a high turnover in employees, Burger said.
“We’re not jumping around, we’re improving incrementally,” Constance said.