The Brown County Health and Wellness Center is now open five days a week because of the volume of patients it serves.
In October, the Brown County Commissioners voted to provide clinic memberships to county employees.
The clinic, which opened in January at Brown County Schools’ Eagle Park, currently serves 900 patients, including Brown County Schools employees who can use it for free through their insurance plans.
After paying for memberships, the move is projected to save the county $138,029, according to a return on investment proposal provided by Wellness for Life, which operates the clinic.
Savings will come from employees seeking primary care at the health clinic instead of at other doctors’ offices. The biggest savings is projected to be nearly $190,000 on generic and brand prescriptions that can be filled at no cost to the employee at the clinic.
The clinic had been open only two days a week, but after picking up new patients from Edinburgh-based company Manar in October, it was able to expand to five days a week, said Rodney Clark, an account executive for Wellness for Life.
The clinic offers primary care services to anyone who pays a monthly membership fee.
The retirement of Dr. John Alessi last month, resulting in the closing of Columbus Regional Hospital’s Nashville Family Medicine office, was one reason county leaders decided to look into offering memberships to county employees, said county commissioner Diana Biddle.
School district leaders had been hoping to partner with the county on this clinic for months, but no decisions had been made yet. Alessi leaving was a “game changer,” Biddle said.
“We have had people come into our office every day since the letters (from Nashville Family Medicine) went out because they weren’t going to have a primary care physician. They were losing the doctor there,” Biddle said at the Sept. 24 Brown County Council meeting.
Clark said Wellness for Life saw a “small increase” in the clinic’s patient load after Alessi’s office closed. “We are available to take them on if they would like to join the clinic,” he said of Alessi’s patients.
Memberships for adults start at $65 a month and can be cancelled at any time.
On Oct. 30 Kelsey DeClue, public relations coordinator for CRH, said that there were no updates about the future of Alessi’s former office space in Nashville, but CRH wanted people to know that they have a new practice on the west side of Bartholomew County.
MyCare Family Med was set to open on Nov. 1. It’s off State Road 46 East at 4001 Goeller Boulevard.
“I understand this is not an in-town option for Nashville residents, but it is within close proximity and the practice will have extended and weekend hours,” DeClue said in an email.
MyCare Family Med will be open from 7 a.m. to 7 p.m. Mondays through Fridays and 8 to noon on Saturdays. Same-day appointments will be offered whenever possible, she said.
‘Profound’ impact
Clark and Brown County Schools Superintendent Laura Hammack attended the September county council meeting to provide more information about the clinic and how it has impacted the school corporation’s finances.
“Our health insurance model was a disaster, really, when I started,” Hammack said. “We were in a situation where we were paying $600,000 and $700,000 lump sum payments out of our general fund in order to catch up our health insurance fund.”
By opening the clinic at Eagle Park, Hammack said the impact on the school district’s health insurance fund has been “profound.”
“We are sitting right now with a health insurance fund of a little over $700,000. It’s an extraordinary thing,” she said. “… It’s almost a million and a half dollars that is a total amount saved. That’s massive in this short amount of time.”
Wellness for Life bills the school district monthly. “What’s happening is the services rendered are controlled because they are in our own space. We not paying rent; we own the facility. … Basically, what you use is what you pay for,” Hammack said.
Not only is the school district saving money in the health insurance fund, but the employees are enjoying having a clinic available to them in their own community, Hammack said.
County government’s health insurance fund has been stretched as well. For 2018, the county has had to appropriate almost a million dollars to help cover health insurance, including $800,000 just in September.
School district leaders wanted local government to consider partnering with them on the clinic because their success “has been so extraordinary,” Hammack said.
The monthly cost to the county will be about $58 per employee, for a total of $17,000 a month for 115 employees, said county human resources coordinator Melissa Stinson.
Clinic services are available to county employees, officials and retirees at no cost to them through this arrangement. Those employees not on SIHO insurance or state employees would pay $10 each paycheck to have access to the clinic.
Under the partnership, children would cost $10 each and $55 for other adults in the family. Combos are also available for families, Stinson said.
Biddle said she was concerned that partnering with the clinic would duplicate services already offered under the county’s self-insured plan with SIHO Insurance Services, but it doesn’t work that way.
“If we spend it with them (Wellness for Life), we’re not going to spend it with SIHO. It really does not duplicate,” Biddle said.
The hope is that employees will choose to go the clinic instead of traveling to their general practitioner, who may be out of the county, or going to the emergency room for minor issues.
The commissioners approved the contract with Wellness for Life on Oct. 17.
“We’re up to $1.4 million across all our funds for health insurance. With the projected savings they are talking about, I think we can do it within the funding we currently have,” Biddle said.
The breakdown
According to the clinic’s proposal, the county spent about $1.4 million on medical and pharmacy costs in 2017.
The total cost to operate the clinic per year for the county is projected to be about $127,596, according to Clark. That’s about $10,000 a month.
Wellness for Life projected a total savings for the county at $265,625, but after the cost of the clinic is subtracted, the savings ends up being around $138,000.
Stinson said since conversations started about joining the clinic, she had four employees come in and ask if the county had signed up because they didn’t have primary care physicians, even before Alessi retired.
“One of them had a severe earache and needed to go to the doctor. Instead, that person ended up going to an urgent care in Bloomington, so that just cost us a lot more money I’m sure,” she said.
The savings comes from Wellness for Life offering primary care, specialty services and urgent care services to county employees via the clinic or a 24/7 hotline. People can call the hotline and speak to a provider who can help them understand symptoms they’re having, give medication advice and treat minor illnesses or injuries.
The providers can even do video calls and text message pictures. Wellness for Life has more than 25 clinics in Indiana with more than 40 providers who have access to medical charts. Five of those providers are on call at any given time, Clark said.
Most medications can also be filled at the clinic’s pharmacy free of charge. If a medication is going to cost the patient, clinic employees will look online to find the best price and where to get it, Clark said.
“Those chronic disease medications, you will get 90-day supplies. You don’t have to go every 30 days to CVS. It’s right there in-house,” Clark said.
The clinic does not prescribe opioids, Clark said.
If a lab or a medication is not available at the clinic, the providers can still write an order or prescription for their patient at a different location.
“If we find you need an MRI or CT scan, we’re not just going to send you to the hospital that owns us. What we’re going to do is we’re going to look for the best price around. You may have to drive 30 or 40 miles, but it’s going to save you $400 or $500 or more,” Clark said.
“We’ve done the research to help get the right price and get the right care.”
Accessing services
Clark said Wellness for Life would also consider doing an urgent care center partnership with the county on the weekends for people who get injured in Brown County State Park or even walking around downtown Nashville.
Stinson said a lot of ambulance runs are for a broken arm or something that could be handled by an urgent care visit. X-rays can be done at the clinic for $60.
“There’s a lot of fall-downs and scraped knees in the park and in the town of Nashville. We’re transporting and paying for that transport. If it happens to be somebody who refuses to pay that, we end up paying it,” said council Vice President Dave Critser.
At the Oct. 3 commissioners meeting, Stinson said a survey was given to 69 employees on how likely they were use to the clinic. Sixty-five said they would use it.
“I already have people calling me and asking me, ‘I have a sore throat; can I go on out there?’ I do think it will be something that will be utilized,” she said.
Commissioners Jerry Pittman and Dave Anderson expressed support for the project at the last two commissioner meetings.
“I was a little skeptical at first that it might be a duplication of services here. After looking at it, I think it has a really good chance of saving the county maybe $100,000 to $200,000 a year on our health costs,” Pittman said.
“I like the fact that we’re not tied down to the three- or five-year contract. We can get out of it with a 90 day notice if it’s not working out. I don’t see any down sides.”
Sherrie Mitchell, a candidate for county council, questioned the savings.
“Even if you provide this, some people won’t go. Some people just don’t go to the doctor. Opening this up won’t make it happen,” she said at the Oct. 3 commissioners meeting. “If we’re not already incurring $150,000 in GP (general practitioner) costs, then you are incurring an expense we do not need.”
Pittman said the decision to join the clinic was not a “rash decision.”
“We’ve gone over all of the numbers and looked at the probability of us saving money. I think there’s a high probability of it will save money. If it turns it don’t, 90 days and we’re done,” he said.
“There’s a tremendous incentive for people to utilize this, because instead of paying a $20 co-pay, they are going to pay nothing to go to the doctor.”
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Since 2011, Brown Countians for Quality Healthcare have been working to find a way to provide healthcare to all residents.
Now the group is taking another step by providing scholarships to people who wish to access medical care through the Brown County Health and Wellness Center.
The group has been awarding scholarships since May. They have spent $2,100 on scholarships for eight families including 11 adults and six children.
The Brown County Community Foundation awarded an $1,800 grant to the group that is included in that total.
“Brown County, statewide, looks under served. We have fewer physicians available, only one dentist in town. Now, of course, we’ve lost the Columbus link (with the retirement of Dr. John Alessi at Nashville Family Medicine), so the need is even greater in terms of service,” said Judith East with Brown Countians for Quality Healthcare.
Anyone who wishes to apply for a scholarship can do so by calling board President Bill Todd at 812-720-0886.
The group is also looking for funding to ensure they can cover the scholarships for as long as people need them.
“We’re down to about a month and a half worth of continuing scholarships,” East said.
The clinic hours have been extended to five days a week, which will help people access it more, East said. “We’ve had some people who have signed up for the clinic, but because of their limited hours they’ve had difficulty getting in, so this will make a big difference,” she said.
The group gets a discounts on memberships from Wellness for Life, but they still need assistance with securing funding for current and future scholarships.
Anyone who wishes to donate can send money to Brown Countians for Quality Healthcare at P.O. Box 1382, Nashville, IN 47448. Checks can be made out to Brown Countians for Quality Healthcare.
Questions about scholarships can also be directed to Todd by calling him, East said.
In 2012, graduate students with the Kelley School of Business at Indiana University conducted a study and identified Brown County as a “needy county” in the state when it came to healthcare needs.
“They specifically looked at obesity, smoking and diabetes as major needs in our community and suggested it might be nice to have a federally qualified health clinic here in town. But there’s a lot of hoops you have to jump through to meet the qualifications for that, so we’ve just been looking at alternatives,” East said.
The group had previously approached Brown County Schools and the county government with forming a clinic similar to Activate Healthcare in Monroe County where the county government provides an on-site clinic for its employees. “They weren’t interested at the time,” she said.
At the same time, the group found out about Wellness for Life, which operates the Brown County Health and Wellness Center, Laura Hammack took over as schools superintendent and began looking at Wellness for Life, too.
“She (Hammack) recognized the value of it and jumped on it. Now we have this clinic. They are already saving money, and the county has seen they are saving money and they are finally buying in,” East said.
“It’s all coming together, finally.”
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WHERE: Brown County Schools’ Eagle Park, 1749 State Road 46 East
HOURS: 9 a.m. to 6 p.m. Mondays and Thursdays; 7 a.m. to 4 p.m. Tuesdays, Wednesdays and Thursdays. Closed for lunch from noon to 1 p.m.
PHONE: 812-720-3297
MORE INFORMATION: bcsc.healthcare-redefined.com
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