Mobile County Commission considers employee healthcare clinic to reduce costs

MOBILE, Al.
The Mobile County Commission is considering creating its own clinic for employees in order to reduce its healthcare costs.
All employees, retirees and their adult dependents would have access to the clinic for primary care visits at no cost.
The county would retrofit its Michael Square property off of Azalea Road in west Mobile at a cost of about $200,000 and pay Infirmary Health Medical Clinics PC, an arm of Mobile-based Infirmary Health, about $640,000 annually to staff and run the operation.
The County Commission is set to vote on a contract with Mobile Infirmary on Monday.
"This is truly a win-win for the county, the taxpayers in the county and for county employees," County Administrator John Pafenbach told the commissioners during their Thursday work session.
County officials said that the clinic could pay for itself in the first year and help control costs even more in the long term.
The county, which self-insures its 1,500 employees, expects to pay about $15 million in claims this year, said Donna Jones, director of general services. And costs keep going up, increasing at an average of about 6 percent every year, she said.
According to the county, it costs about $133 every time that an employee or employee's dependent visits a family doctor. Less the employee's $30 co-pay, that leaves the county with a bill of about $103.
In 2010, there were about 16,650 visits by the county's insured employees and their dependents.
The clinic concept isn't simply about reducing costs, according to the county. It could also help encourage employees to practice preventive care.
Many of the county's employees are older and earn relatively low wages, so a $30 co-pay might dissuade someone from going to the doctor when he or she is sick.
A skipped visit might save the county $100 in the short term, but if the illness progresses or becomes chronic, the county could end up spending many times that amount later for emergency room visits or inpatient care at a hospital.
Chronic diseases are especially costly.
In 2011, 11 claims cost the county about $2 million, said Jones. She said that half of that cost was associated with treating employees or dependents that have kidney failure, a common complication of poorly managed diabetes or high blood pressure.
The county buys reinsurance to handle such catastrophic medical costs, but such policies can be expensive.
The clinic will also run a wellness program, a form of preventive care that emphasizes healthy lifestyle choices.
Such clinics, often known as "workplace clinics", are becoming popular in both the public and private sector as a means of reining in health costs, according to the Center for Studying Healthcare Change, a Washington, D.C., think-tank.
Companies that run workplace clinics often tout returns on investment as high as 7 to 1, according to a 2010 study published by the center. However, returns of 2 to 1 are more common, according to one consultant quoted in the study.
Mobile County officials said that they decided to try the clinic after talking with their counterparts in Montgomery County, who reported saving $1.3 million over three years with a similar program.