A statewide network of walk-in clinics has agreed to pony up $36 million to resolve a contract dispute with the insurance agency covering state employees after officials last year discovered the vendor wasn't providing the return on investment previously promised.
Lawmakers rubberstamped a contract amendment Wednesday allowing thousands of state workers with insurance plans through the Office of Group Benefits to continue to use AccessHealth urgent care clinics for at least another year without having to pay out-of-pocket expenses.
The agreement puts an end to a dispute that spilled into public view earlier this year after state officials attempted to cancel the contract with the urgent care providers. That followed an actuarial analysis showing that the state was overpaying for services by the tune of more than $48 million despite a clause in the contract that guaranteed a return on investment.
Once the state put out notice it was cancelling the contract, AccessHealth went on the offensive, emailing nearly 228,000 state employees and all 144 lawmakers to rally against the move. David Couvillon, who leads the Office of Group Benefits, said he fielded hundreds of calls from disgruntled state workers. That helped pushed the state towards the negotiating table and away from costly litigation.
Under the new contract, the state is also off-the-hook for $23 million in payments they would've owed from December 2020 to June 2021. Going forward, the state will pay AccessHealth $2 million a month, down from the more than $3.2 million it owed under the previous contract. It also includes a clause ensuring the state will break even on its investment.
Part of the issue, Couvillon said, was that state employees weren't taking advantage of the benefit. For the agreement to benefit the state, state workers needs utilize the clinics around 10,000 a month. In 2020, monthly visits hovered around 4,600. The new contract includes a provision aimed at boosting utilization.
Some lawmakers Wednesday expressed skepticism over the agreement.
"Why wouldn't we just discontinue the contract if its not working?" asked state Rep. C. Denise Marcelle, a Baton Rouge Democrat. "Why would we then continue it."
Couvillon said his office faced "considerable pushback" from members when they suggested cutting off the service. He said that utilization was down because of the coronavirus pandemic and would likely rise as society returns to normal.
AccessHealth has almost 80 clinics statewide, including Acadiana Access Health in Lafayette; Patient Plus Urgent Care in Baton Rouge; and Doctors After Hours in Harvey, Metairie and New Orleans.