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Mont. says early returns good on health clinic

Matt Gouras, Associated Press

HELENA, Mont. (AP) -- Montana lawmakers were told Tuesday that new state health clinics appear to be helping reduce costs.

The state opened a Helena clinic for employees last summer, an idea championed by former Gov. Brian Schweitzer. Another clinic was later opened in Billings, and more are planned in places with a large number of state employees.

The state pays a per-patient fee to CareHere of Brentwood, Tenn., which won the contract to manage the clinics. The state argues the strategy is cheaper than paying for the profit and overhead of private doctors through a traditional health plan.

Employees are given an incentive with no copays or deductibles when visiting the clinic.

Russ Hill, the administrator overseeing the clinic for Montana's Health Care and Benefits Division, said the state's aging workforce has meant medical cost increases. He told the interim State Administration and Veterans' Affairs committee that the clinics are making it easier for employees to see a primary care provider, which helps to identify problems earlier.

Hill said health care costs last year only increased 3 percent, compared to a 7 percent increase the year before. A similar drop is expected this year. The state says it has also tightened its pharmacy plan, implemented new disease-management programs, put incentives into place and made other changes.

The clinics also have resulted in a drop of about half in the per-visit cost of seeing a doctor, he said.

State Sen. Dave Lewis, R-Helena, said he is not yet convinced the clinics have helped reduce overall costs. And he said it could have an adverse effect on doctors' offices elsewhere in Helena who won't be seeing the patients and may be forced to charge more for some procedures.

"Their feeling is that you are sort of picking the low-hanging fruit, in terms of inoculations and the easy stuff," Lewis said. "Their concern, from the perspective of the local health care delivery system, is you are taking some money that is going to have to be recovered in higher fees elsewhere."

Hill said a more detailed financial analysis will be available later this year that takes a more complete look at the costs and benefits of the new clinics. But he expects it will show improvements.

"In addition, we know we have reduced expensive emergency room visits, and urgent care. We are seeing these long-term costs decrease," Hill said.

Estimates prepared for the clinic's opening last year said it could save more than $100 million over five years.