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Muskingum County sees trend of higher medical costs for insurance plan

Muskingum County sees trend of higher medical costs for insurance plan

County has taken measures to prevent going over budget

ZANESVILLE − Just a few counties northwest, Richland is feeling the sting of rising drug and medical costs that has forced its budget into the red. The cost of GLP-1 medications like Ozempic, Jardiance and Trulicity, typically used to treat Type 2 diabetes, has forced a massive increase in costs when they are prescribed to non-diabetic patients for weight loss.

Richland is now looking at cutting those medications when used for weight loss.

Here in Muskingum County, the self-funded health insurance plan that is administered by MedBen doesn’t cover weight loss drugs.

“Our health insurance plans exclude anti-obesity/appetite suppressant drugs,” said Pam Davis, human resources director. “Unless specific criteria are met through a prior authorization process, which includes medical review.”

But like Richland County, Muskingum County is not immune to rising medical costs due to inflation. And while Muskingum has been able to stay in the black, its only been able to do so by putting preventative measures into place.

“(Medical costs) vary year-to-year but inflation in general is affecting plans across the county and the nation,” said Kenzie Hill, employee benefits specialist at Muskingum County, which has just under 800 benefit-eligible employees. “They have definitely increased, but we have been very fortunate and managed to stay under budget by curbing costs for our employees and the county.”

Hill said the two biggest preventative measures have been creating an Employee Wellness Program and switching to TruDataRX as its prescription medicine provider.

“The wellness program was first implemented in 2020 as a way to utilize preventative measures and catch diseases early to prevent higher costs later on,” said Hill. “It’s a long-term program so it will take time to see the effects of it.”

The prescription initiative that was implemented Feb. 1, 2023, has had a much quicker impact.

“We have seen a reduction in prescription drug costs as (TruDataRX) drives employees to those lower cost drugs, the generics,” said Hill.

TruDataRX claims on its website that it uses “comparative effectiveness research” to “see through the advertising and hype around medications to determine which drugs actually are the most effective at the lower cost.”

Hill said the program works. However, she said, employees are still given “the opportunity to get on name brands if there is a medical necessity.”

And while the county does not cover weight loss drugs, it does cover charges for certain treatments related to tobacco cessation.

“But there are certain limitations in place,” said Hill. “Because of the high cost of it.”

She said another way Muskingum County tries to save money is by staying in network.

“We can get more discounts from certain providers,” said Hill. “So, it’s the same services for better costs.”

She said it’s a tough line to walk making sure employees get quality health care and medications, while also staying on budget for the county.

“It’s pretty difficult because you don’t want to limit employees’ options,” said Hill. “But we provide avenues where they can still have coverage to maintain their health and treat their diseases, while keeping costs low.”

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