Contractor chosen for school health clinic remodel

Mar. 7--Martel Construction of Bigfork has been chosen to complete the remodel of a former vision clinic into a CareHere primary health care clinic at 340 W. Center St. in Kalispell.

The bid for the project came in at $172,000 with a $17,200 contingency. Money from the Kalispell school district's self-funded insurance plan will pay for the remodel.

CareHere will cover startup costs related to furnishings and supplies as part of a five-year contract with the district. The district also signed a five-year building lease at $1,500 a month with an option to buy if the owners decided to sell the building.

The clinic is scheduled to open in the beginning of May and will serve Kalispell Public School employees, their dependents and retirees on the district's health insurance plan.

Medical services treated at CareHere clinics include acute conditions such as a sore throat, cough, sinus and sprains, for example. Other services cover evaluation and management of chronic illnesses such as diabetes or high cholesterol, for example, in addition to lab tests, physicals and other routine care.

The focus is also on preventative care, which is where savings may be realized for both patients and the district -- when patients engage in healthy habits and seek medical attention before symptoms or conditions worsen.

"If people get health care when they need it, long-term health care will be less expensive," said Kalispell Director of Business Services and Operations Gwyn Andersen.

Insurance and health care have been topics of much discussion in the district since it went to a self-funded insurance plan that was approved in 2013 by the school board to mitigate premium increases to employees, which at the time, was said to be 16.5%.

Opening a primary health-care facility is part of ongoing efforts to control costs as the district's self-funded insurance plan sits at roughly a $600,000 deficit, due in part to high claims. The deficit would have been significantly higher if not for the protection of stop-loss insurance, which is set in motion when large claims exceed a certain monetary threshold.

In 2017, the district floated a $725,000 loan from its interlocal fund to cover the deficit -- and may have to do so again -- but the district is also expecting to see savings after the clinic opens, to help bring the fund back in the black. With health-insurance premiums as the only source of revenue, rates are also expected to increase, according to Andersen, who noted that was slated to happen regardless of whether the clinic opened or not. The exact percentage increase will be known in April.

In CareHere's September 2019 proposal to the district, the company provided a cost and savings analysis showing a net savings of $207,298 in the first year, dependent on at least 2,280 patient visits. Getting people to use the clinic will be the next challenge, according to school officials. About 550 Kalispell Public School employees are on the district's health insurance plan. The district employs roughly 750 people.

The district thinks participation can be accomplished through the appeal of a zero copay for clinic visits for insurance members enrolled in the district's "managed care plan," whereas it's currently a $30 copay. Patients also may make appointments online 24/7, which may also interest staff who are not currently on a district insurance plan.

The district entered into the agreement with CareHere last fall after extensive research by the district, school board, insurance consultants and school board financial and health insurance committees.

CareHere partners with employers to provide medical services to their employees by providing administrative services and hiring medical professionals to operate clinics and maintain medical records in compliance with the Health Insurance Portability and Accountability Act, according to the company. The company manages more than 200 health and wellness centers in 22 states, including Montana Health Centers that serve state employees.

Ongoing costs to the district includes a $15 administrative fee per employee. The insurance premiums employees pay, which also include a district contribution as an employee benefit, will go toward covering annual costs.

Reporter Hilary Matheson may be reached at 758-4431 or [email protected].

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