Insurance board's worries snag plan for LR state employees clinic

A proposal to use money from state employees' health plans to help establish a clinic for state employees near the Capitol stalled Tuesday after members of a state insurance board complained that they hadn't been fully briefed on the idea.

Members of the State and Public School Life and Health Insurance Board expressed concern about the cost of the clinic, which would be operated by the University of Arkansas for Medical Sciences, and about whether money from the plans could be legally spent on it and whether subsidizing it would give UAMS an unfair advantage in competing with other health care providers.

In a voice vote, with no members dissenting, the board approved a motion by member Shelby McCook to refer the proposal to the board's benefits subcommittee for further study.

At McCook's request, the board also agreed to ask for an opinion from the attorney general on whether money from the plans could be spent on the clinic, and from the Legislative Audit Division on the "feasibility and legality of doing this."

McCook said he was concerned about "gambling trust fund money on a business startup" and about helping UAMS compete with other health care providers.

"I feel very strongly that government should do what only it can do, or what it can do best," McCook said. "We do a really good job of providing insurance coverage, but I don't know how well we're going to be at managing clinics."

Bob Alexander, director of the state Department of Finance and Administration's Employee Benefits Division, which manages the health plans, told board members the clinic would cost the plans money upfront but generate savings in the long run by curbing the growth of employees' health care costs.

"The long term is what we're looking at -- how can we help our members gain healthier lifestyles or early intervention in possible conditions," Alexander said.

Alexander had planned to sign an agreement with UAMS officials this week and present it to the Legislature for review next month, with a goal of having the clinic in operation by July.

He said after the meeting that he would follow the board's direction but isn't required to seek board approval for contracts with vendors or agreements with government entities such as UAMS.

The State and Public School Life and Health Insurance Board sets the benefits and rates for the plans covering about 28,000 state employees and 46,000 school employees.

A former attorney with the Insurance Department who previously served on the health plan board, Alexander said he began exploring the idea of a clinic for state employees soon after the board hired him in August 2013 to take over as director of the Employee Benefits Division.

In addition to UAMS medical staff members, Alexander said, the clinic would be staffed by employees with American Health Holding, which provides case management for state and public school employees with large medical bills, and ComPsyche, which runs the employee assistance program.

Under a preliminary proposal, the clinic would be open to anyone, but state employees would be able to access it for free. The clinic would set a target of allowing at least 85 percent of state employees who visit the clinic to complete a doctor's visit within an hour, R.T. Fendley, chief strategy officer for UAMS Medical Center, told the board.

By providing more convenient access to the 16,500 employees who work within about two miles of the Capitol, Fendley said, the clinic would help identify employees with chronic health conditions, such as diabetes or heart disease, while reducing the time employees are absent due to illnesses.

The clinic would also help attract more patients for UAMS and generate referrals to specialists at other UAMS locations, he said.

Fendley said the cost of the clinic, including start-up costs, would be about $1.5 million a year for the first five years. The health plans would be responsible for 80 percent of the cost, with about half of that expected to come from billed charges for employees' doctor visits.

McCook, the chairman of the benefits subcommittee, complained that he first heard of the plan for the clinic at the board's meeting last month, "and then what I read about it in the paper told me more."

"All this should have gone through the benefits subcommittee," McCook said.

Andrew Kumpuris, a cardiologist affiliated with CHI St. Vincent Infirmary and Baptist Health Medical Center in Little Rock, said he wanted more information about the clinic's costs, the services that would be offered and the projected revenue. He said the board might want to explore whether it could get a better deal by soliciting proposals from other organizations.

"If we're going to do this, we need to kind of think it through a little better," Kumpuris said.

A section on 11/19/2014

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