Meeting Called to Order by Thomas Woodruff
Financials and Dashboard - Milliman presented the monthly dashboard report for financials. Pharmacy costs are increasing, creating a shortfall in the retiree budget. Milliman reported that the main drivers in the higher pharmacy costs are significant increases in the AWP for specialty drugs, utilization of compound drugs, and an increase in the new drugs coming to market. Staff reported that we are projecting a significant shortfall in the retiree appropriation for fiscal year 2015 which will need to be monitored closely.
Medical RFP Update - Tom reported that letters of intent were received and the deadline to submit proposals is January 14, 2015.
ER Audit Update - Tom reported that both carriers found significant up-coding at Middlesex. A report from each carrier, including next steps, will be presented in January 2015.
Facility Fee Update - Josh reported that the informational forum held on 12/3/14 was attended by hospitals, insurance companies, physician groups, and other stakeholders. Based on information presented, the emerging issues are that facility fees are being charged at locations that have consolidated with larger hospital systems. The second issue is the necessity to determine the total cost of care between independently owned facilities and hospital systems, and the last issue is to document the price differentials.
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