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Commissioners table PEIA insurance switch after hospital CFO proposal

May 24, 2019

HUNTINGTON - Cabell County commissioners agreed to hold off on a decision to switch health insurance providers for the county’s 304 employees after the CFO of St. Mary’s Medical Center offered to help negotiate lower costs with its current provider.

Commissioners tabled a decision about switching health insurance coverage from Highmark Blue Cross Blue Shield to the PEIA Health Plan until its next meeting June 13. Switching providers would save the county approximately $344,000 a month, according to a cost comparison memo provided by Pete Thackston, senior vice president of USI Insurance Services.

St. Mary’s Medical Center CFO Angie Swearingen asked commissioners to hold off on the decision before Thackston was about to give a presentation on the benefits of switching to PEIA, which is West Virginia’s public employees’ insurance system.

Swearingen is in charge of managed care for Mountain Health Network’s Cabell Huntington Hospital and St. Mary’s Medical Center. The two hospitals joined Huntington Internal Medicine Group and Marshall Health to form an Accountable Care Organization (ACO). An ACO is a group of health care providers that come together voluntarily to coordinate high-quality care for the Medicare patients they serve.

She said if the county would agree to work with the ACO, they would negotiate lower health care costs between the county and Highmark.

“The ACO gives us an ability through Medicare to help manage those costs through an insurance provider,” Swearingen said. “Highmark is a (third-party administrator) that both St. Mary’s and Cabell Huntington uses to manage their cost of care.”

Commissioner Kelli Sobonya asked if other county commissions within the state have worked with similar ACOs. Swearingen said she was not aware of any, but noted that many ACO models are working throughout the country to benefit their communities.

St. Mary’s Medical Center and Cabell Huntington Hospital are currently looking at ways to reduce their health care costs through the ACO, she said.

“We have been very successful at St. Mary’s in looking at things like diabetes and how we can have a benefit to employees who are participating in their health care, to offer them free supplies if they go through the regimen of getting their tests done and having the appropriate medication, et cetera,” she said.

If the county agreed to work with the ACO, it would be the first organization to do so. Commissioner Jim Morgan said he was unsure if the county should be the guinea pig for the ACO program.

Commission President Nancy Cartmill said she had been approached by several other companies seeking to help the county lower its health care costs. She made a motion to table the PEIA presentation until they could hear more from Swearingen and the other companies. Cartmill and Sobonya voted in favor of the motion, while Morgan voted against it. Morgan said he thought they should hear Thackston’s PEIA presentation and then make a decision at a later date. Applause broke out from those gathered in the audience after the presentation was tabled.

Abby Reale, assistant administrator at Cabell Huntington Hospital, made a similar request on behalf of the ACO before Swearingen made it to the meeting. Reale is Sobonya’s daughter.

According to the cost-saving memo provided by Thackston, the county spends approximately $607,000 a month for employee and family plans with Highmark. The county would spend approximately $263,000 a month if it switched to PEIA’s family and employee plans.

Travis Crum is a reporter for The Herald-Dispatch. He may be reached by phone at 304-526-2801.

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