HomeMy WebLinkAboutDOC Clinic Memo
TO: BOARD OF COMMISSIONERS
FROM: DAVE INBODY & RONDA CONNOR
SUBJECT: ON-SITE EMPLOYEE HEALTH CLINIC
DATE: 8/31/2012
CC: ERIK KROPP
Background on Deschutes Onsite Clinic (DOC)
On February 3, 2011, the Deschutes Onsite Clinic (DOC) began providing health care for
County employees and their families at no cost. Instead of relying on the fee-for-service
model for delivery of health care services, an organization was contracted to operate the
DOC for a monthly administrative fee with all other costs being passed through to the
County. The notion is that such a model allows the County to save the health benefits
plan expenses provided an adequate number of patients are seen at the DOC. Since the
costs are fixed, the more patients seen at the DOC, the more savings are incurred by the
DOC.
Healthstat, Inc., based out of Charlotte, North Carolina, was selected to operate the DOC.
The primary reasons the selection committee gave for selecting Healthstat to operate the
DOC were their experience with clinics similar to the model Deschutes County had in
mind and their having established clinics for other city and county governments. A two-
year contract was signed with Healthstat.
Initial estimates indicated that Deschutes County could feasibly breakeven within the first
year and experience annual savings of at least $250,000. The DOC actually broke even in
eight months and, saved the County $534,415 in the first 18 months. Employees saved
$258,583 during the same time period. The DOC had 7,399 office visits, conducted 4,228
labs and wrote 6,615 prescriptions, 2,569 of which were filled at the DOC’s
pharmaceutical dispensary in the first 18 months. The DOC saw 1,399 different patients
at least once, representing about half of all covered lives on the health benefits plan, and
about 70% of all employees.
2012 RFP Process
With the Healthstat contract expiring on December 31, 2012, an RFP process was
initiated in June 2012 for operation of the DOC. Although the County had the option to
extend the existing contract with Healthstat, it was believed to be in the best interest of
the County to compare the current fees and service delivery to other vendors in the field.
Eight proposals were received in response to the RFP. A committee was formed to
review the proposals and provide a recommendation to the Board of Commissioners for
approval. The committee consisted of the following members:
2
Ronda Connor – Health Benefits Coordinator, responsible for overseeing the
DOC
Dave Inbody – Assistant to the County Administrator, responsible for overseeing
the DOC
Erik Kropp – Deputy County Administrator
Timm Schimke – Director of Solid Waste and Employee Benefits Advisory
Committee Chair
Kate Moore – Program Manager in Health Services Department and Registered
Nurse
Therese Madrigal – County Wellness Coordinator
Jennifer Floyd – Senior Web Applications Developer in the Information
Technology Department and member of the Employee Benefits Advisory
Committee
Kelly Elzner – Employee of Central Oregon Intergovernmental Council
After reviewing the proposals, the committee selected five vendors to make
presentations. Through this process, two additional vendors were eliminated. The
remaining vendors were Medcor of Chicago, CareHere of Nashville and Healthstat.
Medcor and CareHere were provided follow-up questions, current and former clients
were contacted, conference calls were scheduled and site visits were made to examine
each vendor in greater detail. This resulted in Medcor being selected unanimously to
operate the DOC. Some of the reasons identified by the committee for selecting Medcor
were the commitment they placed on building a strong relationship with the County, a
clear explanation of the services they can and cannot provide, an understanding of the
County’s vision for the DOC, and the consistent and attentive service provided to their
current clients.
Transition Plan
During the next three months, the County will work closely with both Healthstat and
Medcor to transition operation of the DOC. Medcor provided a detailed transition plan as
part of their proposal (attached). Through the RFP process, the committee identified
several components of the transition that will be critical to its success. Continuity with
staff, hours of operation and services provided will be imperative to ensure employees’
health care needs are still being met. A transfer of electronic medical records will also be
necessary. Fortunately, both Healthstat and Medcor use NextGen as their EMR software,
which should make the process run more smoothly. Finally, communication with
employees regarding the transition will be important. Medcor will meet with departments
to introduce themselves and their philosophy for operating the DOC.