Healthcare Cost Containment Committee Minutes
February 6, 2012
Meeting Called to order by Tom
New Business:
1) Partnership Plan Update
- Potential population 23,700 emps, 50,000 lives (estimated)
- Waiting for approval from OPM on final draft of the Partnership Plan
Rules
- Data was sent to Secretary Barnes on 2/1/12
- OPM/SEBAC have to agree on the rules submitted to HCCCC
- Meeting with New Britain on partnership plan on 2/7/12
2) Experience and budget report
- Milliman presented experience report
- Rates for this year are adequate to cover current expenses
- Low rate increase anticipated for next year
- Rae-Ellen presented analysis based on allotted and appropriated amounts
3) ER and Preventive Service Visits
- Dave Williams presented claim report detailing impacts of changes
- Committee asked for Milliman to drill down the claim data further and
include pharmacy data
- Identify where we can focus communications/education on appropriate use
of ER vs urgent care, and other treatment options
4) PCMH Reports
- Tom/Dave provided update
5) HEP Compliance Reporting
- Scott explained the HEP compliance grid that illustrates the criteria
for meeting the requirements of HEP
- Tracy handed out a draft of the HEP Compliance Notification Form
- Committee provided feedback
- Committee requested a FAQ document for this program
6) Rx Update
- Joanna Penta presented some cost-saving opportunities for our plan
- Cost savings can be achieved through implementing a step therapy
program, adding exclusions on pain drugs, and implementing a fraud/abuse program
7) Dental Cleanings Update
- Margie Sansone from United confirmed that a fix was in place to cover
the dental cleaning, exam and x-rays for HEP members at 100%
- United was working on an audit to review claims prior to the fix to
ensure they are reprocessed and paid correctly
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