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County to refocus health plan to cut costs

Commissioners hope to save $13.7-million annually by focusing on prevention, eliminating some redundancy.

By BILL VARIAN
Published November 10, 2005

TAMPA - Hillsborough commissioners approved a major revamp for the county's indigent health care plan Wednesday that seeks to stem the cost of the program by refocusing on preventive care.

The vote came as commissioners received news that the cost of the roughly $100-million program came in slightly under budget for the last fiscal year for the first time in a few years, thanks in part to minor changes in the past year.

Commissioners hope the larger makeover will bring financial stability to the celebrated program, and perhaps even enable the county to expand its enrollment.

"I'm very happy," said Commissioner Mark Sharpe, who headed a study group of health care professionals and other interested citizens that reviewed the program over the past six months. "I think it's going to be good for the county."

The overhaul's centerpiece is an emphasis on education and disease management for those suffering from asthma, chronic heart disease and diabetes. The program targets those three ailments because they are common to many of its patients, and they respond well to treatment.

The goal will be to give people treatment early and teach them how to better care for themselves, to keep their conditions from worsening and requiring trips to an emergency room.

Also, instead of treating patients through four networks, commissioners will seek bids from one provider, hoping for savings by eliminating redundancy in administrative costs and by better tracking patients.

The county will still oversee and run the program. County officials estimate the potential savings to be $13.7-million annually.

Commissioners agreed to conduct the study after several years in which the program cost more than the county took in with the half-cent sales tax that was supposed to pay for it. Commissioners voted 5-0 to accept the study group's main recommendations, with Brian Blair and Ken Hagan out of the room. The county plan provides medical treatment to the poor for free in an effort to keep them out of more costly emergency rooms. Wednesday's debate centered on whether the county should impose some form of modest copayment on the patients. Currently, the roughly 15,000 people typically enrolled each month only pay a $1 copayment for prescriptions.

Commission Chairman Jim Norman advocated requiring at least a minor sum to help offset costs. Nobody should just get free health care thanks to taxpayers, he said.

Commissioner Tom Scott, a pastor who has often spoken of growing up poor, said the other board members have little concept of what it is like to be truly destitute and be forced to choose between food for the children and health care.

"I know when you don't have any money and you are being asked to pay a dollar," Scott said. "People will not go."

At some point during the discussion, Blair remarked that he has heard that the average person "in this sector" pays $20 a week for cigarettes and lottery tickets. He did not say where he heard it.

Commissioners ultimately agreed with a proposal by Commissioner Ronda Storms to later consider a modest annual enrollment fee that wouldn't be tied to individual doctor visits.

[Last modified November 10, 2005, 01:20:16]