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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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