— Kandiyohi County is transferring ahead to turn out to be a full associate in PrimeWest Well being.
Almost three years after deciding to affix the regional consortium of Minnesota counties for managing publicly funded well being packages for low-income populations, the board handed a movement at its Nov. 15 assembly to finish the method, together with approving a monetary contribution to the group’s risk-based capital fund.
“I’m actually excited we’ve gotten so far,” stated Commissioner Corky Berg. “We now have been speaking about this for a while.”
Kandiyohi County Well being and Human Companies Director Jennie Lippert advisable the county be part of PrimeWest after she gave a presentation on the Nov. 15 board assembly on the 2023 well being plan awards.
“We must always, as a Kandiyohi County Board, choose in to affix PrimeWest, give that monetary contribution,” Lippert stated. “I feel having them in our group goes to be a profit in lots of, some ways.”
Contributed / Kandiyohi County
PrimeWest operates as a county-based buying settlement, which permits member counties to behave as a well being plan supplier, together with negotiating supplier contracts, coordinating well being care companies and managing threat. As a result of PrimeWest is owned and held accountable by the member counties, it’s believed it gives extra personalised service for these counties.
“They actually develop and design packages to assist members get pleasure from more healthy and fuller lives, and so they do that with a lens of rural well being care,” Lippert stated.
To totally be part of PrimeWest, the county might want to make a contribution to the group’s risk-based capital fund, which is used if well being care prices for a member county find yourself being greater than estimated.
When Kandiyohi County first determined to affix, its contribution was estimated at $3.6 million, as a result of thought that all the 12,700 folks enrolled within the varied well being packages within the county can be added to PrimeWest.
“They should have a reserve based mostly on the variety of enrollees they’ve of their well being plans,” Lippert stated.
Now although, when solely about 2,700 individuals are estimated to decide on PrimeWest as their plan supplier, the county’s buy-in has dropped to solely $258,523.
“It’s an unbelievable discount,” stated Commissioner Roger Imdieke.
Each 5 years, the state and counties undergo a course of known as procurement, which decides which medical health insurance firms can present the plans for 5 totally different publicly funded well being packages — Pay as you go Medical Help Program, MinnesotaCare, Minnesota Senior Well being Care Choices, Minnesota Senior Care Plus and Particular Wants Primary Care.
In January 2020, when the county first determined to affix PrimeWest, the hope had been that the state would enable counties to have just one well being plan supplier similar to PrimeWest.
“We now have a statute that clearly defines that,” stated Commissioner Rollie Nissen.
Nonetheless, the state has up to now not allowed that to occur. When the newest procurement happened in 2021, PrimeWest wasn’t even chosen as an possibility, which led to Kandiyohi County holding off turning into a full member.
The state, attributable to counties pushing again and threats of lawsuits, determined to halt the procurement course of and preserve issues as they have been. That also meant Kandiyohi County could not use PrimeWest, because it was not a plan supplier in Kandiyohi County previous to 2021.
Minnesota Division of Human Companies simply restarted the procurement course of this summer season however once more the state didn’t rule the way in which Kandiyohi County had hoped.
Whereas PrimeWest is now an possibility for shoppers in Kandiyohi County, it’s not the one one. This implies county employees might want to be taught the ins and outs of two to a few totally different well being plans relying on this system, making for lots extra work.
“It does put the burden on the native items of presidency when you have got additional plans,” stated County Administrator Larry Kleindl.
Whereas the board is upset the state hasn’t allowed it to go to a single-source system, the commissioners nonetheless really feel there are main advantages for becoming a member of PrimeWest presently.
Since PrimeWest has sued the state over its procurement determination, there’s at all times the possibility Kandiyohi County may find yourself seeing all of its well being care shoppers going to PrimeWest. Having the possibility to slowly add shoppers to PrimeWest, as an alternative of all 12,700 folks without delay, may imply a greater transition and the power to create alternatives and packages that match Kandiyohi County’s particular wants.
“I view this as a win-win scenario,” Berg stated. “I actually like win-win conditions.”
