More choices, more cost: County goes with Tenet-HCA health plan
by David Crowder
Posted on December 1, 2008
El Paso County Commissioners Court voted 3-1today to re-award the contract to administer the county’s health plan to Foresight TPA and to go with a plan that makes Tenet and HCA hospitals equals in terms of hospitalization benefits.
The new health benefits plan for 3,800 county employees, dependents and retirees takes effect Jan. 1 and could cost as much as $800,000 more than the plan the county now has.
Although Commissioners Court has several weeks working its way through the issues behind a position Tenet has taken that prevented the county from considering HCA’s best offer, commissioners made today’s decision without hard debate.
“There was not a lot of debate because we have debated this over two meetings for 8 or 9 hours, not including the original meeting where we awarded the original bid to Foresight in October,” Commissioner Veronica Escobar said.
The county and its employees will pay an estimated $10 million for medical care and prescription drugs under the self-funded health plan through Foresight TPA, which underbid Aetna in terms of the monthly administration costs.
Commissioners rescinded their contract award to Foresight because of questions over withheld medical payments that since have been resolved.
The current benefit plan, which expires Jan. 1, gives employees an incentive to go to HCA’s two hospitals – Las Palmas and Del Sol medical centers – by offering to pay 80 percent of their hospital bills there versus 60 percent at Tenet’s.
But this year, Tenet effectively prevented Foresight from again proposing a plan that would put HCA hospitals in a superior position as the county’s exclusive provider organization.
Tenet, however, allowed Foresight TPA to offer the county Tenet’s exclusive provider organization proposal.
Like the current arrangement with HCA, Tenet’s proposal to be the county’s exclusive provider organization (EPO) would have been as much as $800,000 a year less expensive than the plan Commissioners Court approved.
Under an exclusive provider agreement with Tenet, the county health plan would have paid 80 percent of county employees’ bills at Tenet’s two hospitals, Providence Memorial Hospital and Sierra Medical Center, and offered steep discounts on medical charges. The plan would have paid 60 percent of employees’ bills at HCA hospitals.
For a number of reasons, Commissioners Court passed that proposal up for one under which the health plan will pay 80 percent of county employees and dependents’ hospital bills at any Tenet or HCA hospital.
But the price difference did lead Commissioner Dan Haggerty vote against the motion to go with a plan making Tenet and HCA equal preferred provider organizations.
Commissioners Escobar, Miguel Teran and Luis Sarinana voted for the measure. County Judge Anthony Cobos was absent.
The new plan again offers to pay 95 of hospitalization bills for county employees and dependents who use the county’s own Thomason General Hospital.
County employees have that option now but not many use Thomason, in large part because many El Paso physicians opt not to seek privileges to practice at Thomason where most of the care is provided by physicians and interns with Texas Tech University’s two-year Health Sciences Center.
To reach David Crowder, write to email@example.com or call (915) 351-0605
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