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Price tag to go along with state mandate approaches $1 million

Hubbard County's plan for county-based purchasing of subsidized health care continues to move forward, but the price tag may be costlier than commissioners once hoped.

Hubbard County's plan for county-based purchasing of subsidized health care continues to move forward, but the price tag may be costlier than commissioners once hoped.

At the board meeting last Wednesday, commissioners approved a memorandum of understanding with Beltrami and Clearwater counties in order to join the existing county-based purchasing system of Prime-West.

Barring further compromise, Hubbard County can expect to pay about $250,000 more per year.

Negotiations are further hampered by a March 14 application deadline to the Department of Health, said Daryl Bessler, director of Social Services.

"If any of the three counties don't follow through with this, we will have invested money, and we will pay a hunk of money, roughly $93,000, and get nothing," Bessler said.

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Minnesota counties not in a county-based purchasing system by the end of 2007 will be subject to a state mandated pre-paid Medical Assistance program.

The county sought out membership in PrimeWest, an existing coalition of 10 southwestern counties, after plans for a "North Central" three-county network with Clearwater and Beltrami fell through in December.

Bessler updated commissioners on progress at the meeting.

Hubbard filed a request for purchase statement with the state at the end of February, Bessler said.

Now, the state Department of Health needs to verify the feasibility of the proposal. A memorandum of understanding allows the county to apply for a 60-day feasibility study period, but one needed to be filed by Thursday.

There's one small catch, though: payment ratios for Hubbard in the memorandum are higher than the last adjustment, said Bessler.

"Initially, when actuaries were trying to figure out costs, the North Central county-based purchasing plan figured a per-person per-care, monthly cost for Medical Assistance, Medical Care and General Assistance," Bessler said, and these figures were used in initial negotiations with PrimeWest.

According to Bessler, PrimeWest refigured rates based on insurance premiums and demographics, resulting in a significant reduction for the county.

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Estimates for Hubbard County were about 25 percent of the three-county cost, or $613,000, Bessler explained.

He added Beltrami County then approached PrimeWest actuaries to have the figures from the original proposal instituted.

The curent figures for the PrimeWest agreement are almost $250,000 more, said Bessler.

The new arrangement still is not as much as initial estimates of "close to $ 1 million," but is now around $915,000, Bessler said.

"It is significantly higher than the page you or I got, but we're under a March 14 deadline here," said Bessler.

PrimeWest isn't particularly concerned with the ratios, as long as the money is paid, he said.

Bessler proposed approaching Beltrami County with commissioner Don Carlson to work out a compromise, but said, "The reality is, these were the original numbers PrimeWest received."

"In the worst case, it's the best horse in town," said commissioner Lyle Robinson.

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Commissioners also appointed Bessler to be the official contact in correspondence.

In other Social Services action last Wednesday, commissioners:

??Approved the early hiring of a staff member to replace Gary Lampert, who will retire shortly before another employee goes on medical leave.

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