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County Administrator's Report 11. 3.
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| BCC Regular Meeting |
Discussion |
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| RECOMMENDATION: |
Recommendation Concerning the Escambia County Health Clinic - Paulette Stallworth, Interim Human Resources Director
That the Board take the following action concerning the Escambia County Employee Health Clinic:
That the Board choose an option (1 or 2) and authorize the Chairman to execute the appropriate Agreement and/or Contract upon Legal review:
1. Option 1: Exercise the last one-year extension on the July 19, 2016 Contract with Concentra. Cost between 1M - 1.3M. Cost will be determined by the Staffing Model; or
2. Option 2: Select Marathon to provide services at the Clinic. If Marathon is selected, a two-month Contract extension with Concentra to September 30, 2019, will be required. Cost between 1.7M - 1.9M. Cost will be determined by the Staffing Model. Possible additional cost if the present staff is maintained due to a no-compete clause in the contract of $386,172.80 (will be negotiating), with an additional $75,000 for medical record transfer. |
| BACKGROUND: |
The Escambia County Health Clinic was created in January 2011. The Clinic provides Urgent and Primary care as well as all new hire and yearly required physicals for approximately 2000 employees and their dependents (4000 lives) who are enrolled in the County’s health care benefits. Concentra was initially awarded the contact with a 3-year guarantee and multiple extensions. In August of 2016, Concentra was awarded a 2-year contract with optional two 1-year extensions. The current extension with Concentra will expire July 31, 2019, with an option to extend one more year. The Human Resources staff has coordinated with USI, the brokerage firm that provides consultation for the County’s benefits. The Board has previously provided guidance in the selection of the provider for the Clinic.
Productivity - Length of time a clinic visit runs (30-40 mins) vs. the time at primary care, or urgent care visit (1-2 hours).
The following is the time line regarding the Health Clinic RFP:
| Date |
Action |
| October 2010 |
Action of Staff and or USI |
| November 2018 |
Initial discussion with the Escambia County Sheriff's Office and USI on the RFP and our needs for the clinic |
| December 2018 - January 2019 |
USI discussed our preliminary requirements with potential vendors |
| February 2019 |
Escambia County Sheriff's Department & BCC Human Resources finalized requirements. USI solicited proposals from vendors |
| March 2019 |
USI received 6 responses from the RFP |
| April 1, 2019 |
Four finalists made presentations. The Escambia County Sheriff's Office & the BCC Benefits Committee identified Marathon and Healthstat as the “super” finalists. The City of Pensacola was present for the presentation. |
| April 8, 2019 |
John Weber, Benefits Manager & Eric Kleinert, Previous HR Director visited Escambia County School District employee health clinic which is managed by Marathon. |
| April 22-25, 2019 |
John Weber, Benefits Manager visited multiple health clinics within the state managed by Marathon (2) & Healthstat (2). |
| May 7, 2019 |
“Super” finalists’ presentations. The Escambia County Sheriff's Office & the Benefits Committee identified Marathon as our preferred future vendor. The City of Pensacola attended the presentation. |
The vendors were evaluated by importance on the following factors listed:
Medical management (Case Mgt) (Scope of services)
Technology (EMR, Assoc. Portal)
Reporting
Pricing
Corporate Culture
Marketing/Communications
Coaching
Wellness Tracking Challenges
Account Mgt./Customer Service
Compliance
Key components, regarding pricing are performance guarantees, staffing model, chronic disease management, preventive care, and technology provided by each candidate.
Our utilization is running at 45% and the goal is to increase that number to as much 70% employee and 50% dependent, which would avert additional claims costs.
The Benefits Committee and Escambia County Sheriff’s Office representatives support the selection of Marathon based on their presentation which addressed the factors above.
If selected, a three-year pricing Agreement will be included in the Contract and will be brought to the Board for approval for Marathon.
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| BUDGETARY IMPACT: |
The Clinic is funded out of the Internal Services Fund (Fund 501).
Financial Impact:
Current Cost: Approximately 1M to operation (BCC pays 75% - Sheriff pays 25%)
Cost avoidance: (Based on Medicare reimbursement schedule)
BCC claim averted: $ 730,468
Sheriff claim averted: $ 339,718
Firefighter physicals voluntary and career (330) $ 200,000
New Hire Physicals (over 400) cost varies by
occupation $ 51,000
Co-pays received for services $ 8,000
Total Savings $ 1,329,186
Cost of Marathon: If Marathon is selected as the Clinic, there is a no-compete clause to retain the staff. There may be a cost of up to $386,172.80 for the staff and $75,000 for medical record transfer (these amounts are currently under negotiation to lower them). In, addition, Marathon will work with the current vendor to retain the Clinic staff if possible.
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| LEGAL CONSIDERATIONS/SIGN-OFF: |
| Legal will review Contracts once they are received and the Board has decided on the above option. |
| PERSONNEL: |
| N/A |
| POLICY/REQUIREMENT FOR BOARD ACTION: |
The Human Resources Department is seeking which option the Board will propose for staff to coordinate with USI to provide services of an Employee Clinic.
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| IMPLEMENTATION/COORDINATION: |
| The Human Resources Department will coordinate with USI and the selected vendor once an option is selected.
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