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Cooperation a must to limit health costs

June 04, 2002|by BOB MAGINNIS

Starting July 1, state and public employees covered by the West Virginia Public Employees Insurance Agency will pay $26 more per month for health coverage. State officials say that hike won't be the last one and are asking those PEIA covers to use health care sparingly. Restraint alone won't solve this problem, however.

Covered employees are being sent information which warns that going to the emergency room for non-emergency purposes costs $230 as opposed to the $15 charge assessed for a doctor's office visit. But the real culprit is the higher cost of prescription drugs.

PEIA officials told The Associated Press that they'd planned to spend $100 million on prescription medicines this year. Now it looks as if the total will be $105 million or more.

That problem may be eased when the state joins a multistate drug-buying pool, which is expected to begin negotiations with pharmaceutical companies for discounts this fall.

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The savings could amount to $25 million over the next three years, but no one approach will solve this problem. And so PEIA is looking at incentives to get covered employees to save, like free nicotine patches to help smokers quit and a co-pay waiver for those who use generic antibiotics.

Of particular interest to patients in the Eastern Panhandle is PEIA's move to drop some hospitals in other states as providers if they receive more money for treating West Virginia patients than in-state hospitals do. Out-of-state doctors' reimbursements will soon be limited to what in-state doctors get, PEIA officials said.

Finally, there's the malpractice issue, which the legislature worked on in the last session. Now a panel is looking at how to improve on what was done, proposing some limits on witnesses and awards in lawsuits.

Without real progress on that issue, West Virginians could face a shortage of in-state doctors at the same time PEIA is limiting reimbursements to out-of-state physicians. It will take a concentrated effort by public employees health-care providers and state officials to keep the system and its patients healthy.

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