Pennsylvania Prescribes Medical Savings
CLARION, Pa. ? Pennsylvania?s county commissioners are successfully fighting the high cost of inmate medical treatment in jails by using a third-party company to negotiate lower prices from hospitals and pharmacies.
The County Commissioners Association of Pennsylvania sponsors a cost-containment program for county jails, provided by program administrators at a company called Cost Management Plus Inc. So far, the firm is helping 19 of the state?s 67 counties manage the cost of inmate health care.
?We negotiate with pharmacies. We also negotiate with hospitals on behalf of the counties, relating to doctors, ambulance and anything that has to do with the medical care of the inmates,? says Ruth Moraski, president of Cost Management Plus.
?But we don?t provide the actual health-care services,? Moraski told Correctional News. ?We do the auditing and the negotiations, and the county pays the bills. We?re not involved in the way private medical providers are. We?re more of a managed-care function.?
One recent success came at the Clarion County Correctional Facility, where pharmaceutical costs were soaring. Since joining the program in February, the county has cut costs on inmate medication by at least one-third. According to the jail?s pharmacy report, February?s total bill for medications was $9,118. March?s bill totaled $831, April?s bill was $4,401 and May?s bill was $1,987.
Moraski says the program is a natural outgrowth of the Commissioners Association?s traditional role of providing property and casualty insurance to counties. Total jail operation expenses can be as much as 50 percent of a county?s budget, and inmate medical costs are a growing part of the problem.
The Prison Inmate Medical Cost Containment program (PIMCC) was first established in 1994 after an experiment in Cumberland County. ?We?re sort of an offshoot of a project we did for them that had to do with insurance for inmates,? she says. ?It?s very expensive to buy medical insurance for inmates, so we started this program that is basically a third-party administration program to help monitor and manage the costs.?
As part of the cost-cutting effort, Clarion County jail officials are increasing the use of generic drugs and lowering dosages where possible. Warden John Traister says the jail psychiatrist is trying to prescribe generic drugs or wean inmates off drugs altogether.
The full program program includes the procedural manual, discount negotiation, precertification, utilization review, bill audits, on-site staff training, workshops, staff and program monitoring, and trending reports. The cost to a member county with a fully-occupied 205-bed jail would be $25,733 annually, made in monthly payments.
The pharmaceutical component of PIMCC is currently operated through Diamond Pharmacy Services, which serves correctional facilities for adults and juveniles in 36 states.
Moraski is currently focused on marketing health-care program administration to other Pennsylvania counties, but expects someday to help counties in neighboring states negotiate lower health-care costs. ?We?re talking to New York and we?re kicking around the possibility of going down to Maryland, too,? she says.
Contact Cost Management Plus Inc., (717) 234-6628.
