KOLR10 Investigates: Prescription Drug Prices, Part Two

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How do companies balance profit with providing good health coverage to employees? KOLR10 is investigating the rising costs of prescription medications. In part one of this series, a woman described her struggle to pay for life saving drugs. We also learned about the resources available locally to help combat the cost.

There are 1,300 hundred staff members at The Arc of the Ozarks that help individuals with intellectual and developmental disabilities. The turnover rate for Direct Support Professionals, is high — 60%, according to the CEO and President Michael Powers.

“We have to take a good hard look at what we can afford to do and at the same time be able to pay them enough that we can have good retention,” Powers said.

Powers said hitting the bottom line and providing a good benefits plan can be challenging. Out of 1,000 employees eligible, only half opt to take the company’s insurance.

“When we offer benefits to individuals, if they decline, why they’re declining, so we know what the reasons are,” Powers said. “We don’t ask them specifically ask if they’re on medicaid, but we know that a lot of them are.”

Vice President Tim Dygon described the situation, in a recent interview with KOLR10. “So, we’re taking medicaid money to work with people with disabilities and then employing people to be on medicaid,” Dygon said. “It doesn’t make sense.”

The Arc of the Ozarks is lobbying for more competitive pay. It’s at the mercy of lawmakers.

Founder of the The Drew Lewis Foundation, Amy Blansit, said other small businesses have a different challenge.

“When you’re a small company, you’re really at the mercy of which plan can you get,” Blansit said. “The larger your company is, now they want your business, and so rates per person begin to decrease. There’s a lot more financial drain on small companies when it comes to providing medical care for your employees.”

Blansit takes the approach of being transparent about costs with her employees.

“We sat down and looked at, for those who receive insurance, what did the rise mean and for our bottom line,” Blansit explained. “And then all of the sudden 12% now has to magically come from somewhere, and so how then do we as a team address that?”

Educating employees on how to maintain a healthy lifestyle also helps keep costs lower.

“It really goes back to prevention,” Blansit said. “We talk so much about the medical system being so expensive because there isn’t money in prevention. How do we work with staff in order for them to not need the blood pressure medication, obesity is a big one where we have all these code morbidities that go along with it, so what can we do as employers to promote a healthy environment?”

Other employers in town are educating themselves on physicians. Dr. Luke Van Kirk is the owner of Command Family Medicine. His practice provides an alternative to some insurance plans.

“So we do direct primary care,” Van Kirk said. “We work directly with the patients on payment. We don’t bill any insurance or anything, or third parties. Patients just pay us a monthly membership.”

That membership, which costs $50-$75 per month comes with unlimited doctor visits and wholesale prices on medication, lab work, and procedures.

“If a business has a self-funded or partially self-funded plan, they can actually customize those plans, and they can cut out the primary care that I can provide,” Van Kirk said. “They can cut out the prescription plan, the lab work. Basically anything I can do in the office they don’t have to have in the plan, and that brings down the cost of the premiums, usually 10-15% right off the bat. And then on top of that, we reduce the amount of claims that go to the insurance because we’re keeping people out of the urgent care, out of the emergency room. We’re doing most of the medication through our office, not through the insurance plan, so that’s usually a big cost on the insurance claims is the prescriptions.”

While some businesses get creative to combat the rising costs of prescription medication, Blansit said there is something you can do.

“We’re learning as a nation, with the rising cost, how do we stop that?” Blansit said. “That is something bigger than me as an employee, but really it’s bigger than that. It’s voting and getting out and being activists. That’s one thing that we really talk with our families, too. One of the major things that we change is who do we vote into office? What do we do in our civic engagement? We can act.”

Next in our series, we’ll hear from several state lawmakers about their efforts to bring prescription price relief to Missourians.

Copyright 2019 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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