San Angelo's Muddy Health Benefit

San Angelo's Employee Health Clinic is intended to provide less expensive primary care than purchasing services from area providers.  The City's cost for 2010 was $553,493 for 5,400 patient visits.  That's $102.50 per visit.  The city budget called for spending $537,869 in 2011.

SACMC's proposal is to take care of 3,600 visits (5,400 -1800 uninsured dependents) for $475,000 per year, roughly $132 per visit.  On a per visit basis, this is a 30% increase.

Adding a midlevel provider brings the cost to $560,000 to $595,000 per year, roughly $104 to $110 per visit. SACMC wanted to charge a $100 visit fee for uninsured dependents.  Council specified the new uninsured fee be between $10 and $100 and left it to management to negotiate the amount. 

The base SACMC proposal is the most expensive on a per visit basis. It remains to be seen where fees land for uninsured dependents.  Will they be closer to $10 or $100?  Also, it's not clear what happens to clinic revenue, budgeted at $132,400 for 2011.  Does the City keep it or are the revenues assigned to SACMC?

Oddly, the City's July 7, 2010 Early Retiree Reinsurance Program (ERRP) application stated:

Reimbursement through ERRP will allow the City "to continue to provide the same quality of care without passing on additional costs to its participants." 

This statement wasn't true for 2011 health insurance premiums, nor for the City Health Clinic.  ERRP money will be banked until 2012.  That's not the only money that could be brought to bear, given forty five employees or retirees dropped health insurance for 2011. With the forty five gone, the City won't have to pay $357.53 per person per month.  That totals $193,000.

Even more dependents fell from the rolls, but a precise number is not yet available from City staff.  During December open enrollment sessions, HR staff handed out CHIP applications to workers.

The City's commitment "to provide the same quality of care without passing on additional costs" looks hollow.  Shifting risk to the individual or a tapped out Uncle Sam is a greater priority.