FORT WAYNE, Ind. (WANE) — In 2010, Fort Wayne Community Schools faced an annual increase of $1 million in health care costs, which Chief Financial Officer Kathy Friend called “unsustainable.”
“You can’t give people raises and be paying increases like that in health care,” said Charles Cammack, the district’s Chief Operations Officer.
As a result, Cammack spearheaded a three-point plan that seems to be saving millions and, perhaps, keeping the more than 4,000 employees a bit healthier.
“If you are working on employee wellness,” he began, “working on insurance plan design and monitoring the data, you are ahead of the game. Most people don’t do that.”
“The number one thing I tell people is ‘don’t get sick,’” Cammack deadpans.
The district set up a $250 annual incentive, payable just before Christmas, for employees to participate in their own wellness. With annual doctor visits, lab work and better exercise and nutrition, employees can manage or eliminate some chronic conditions or ward off future ones, which keeps them away from costlier treatments or visits to the emergency room.
“People say ‘well, I just got it’ but no, you don’t have to keep it,” Cammack said. “If you do these wellness things, you can get better.”
Since FWCS self-insures, Cammack had the flexibility to adjust what the plan would pay for. He found areas where a little money upfront could become big savings down the road.
For example, Cammack said the best care for diabetics is an established relationship with a nurse, but the old plan paid only for doctor visits.
“The doctor is not engaged with your care. They’re busy,” he explained. “It’s not a slam on doctors, but nurses build a rapport and then they get you to do things that you might not do because you have that relationship. But the insurance policies don’t typically pay for that.”
Cammack also adjusted the plan (a “no-brainer”) to lower the costs of asthma medicines, which significantly dropped the number of asthma-related visits to the ER.
“We’re saving money, and we’re insuring that your health is stable. This is not hard.”
Monitoring the data
“What typically happens is [employers] get a plan and that’s it,” he explained. “They don’t monitor it, they don’t pay attention to how many people are on the plan and they don’t pay attention to any trends.”
Two or three years ago, Cammack and his team noticed a price spike in “specialty drugs.” As a result, the district dropped its pharmacy partner and found someone to negotiate more directly with drug makers.
“And that has saved us probably this year a million dollars,” he said.
Cammack said the current trend is a need for more mental health services and providers.
“So we need to talk to health care providers in the mental health arena and say, ‘what should we be doing and projecting out? How do we provide that service in locations that are accessible, but also how do we get rid of the stigma around getting that kind of help?’”
Cammack said while school nurses care for students, they can become a trusted source for staff, too. The district provided two clinics with a doctor who can serve as a primary care physician, but some employees are suspicious.
“We assure them that we don’t look at individual medical records,” Cammack said. “We don’t know what people are receiving what care. We do look at trends over time, but we don’t have names.”
The school doctor (or physician assistant) can save employees from high co-payments and can lead to a more predictable fixed cost for the district.
“We are going to have a campaign that’s going to promote that more,” Cammack added.