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Consultants: specialty prescriptions and non‑preferred enrollment boosting costs; clinic engagement and case management highlighted
Summary
Benefits consultants told the committee prescription drugs now dominate claim increases and urged greater use of county clinics and case management; a vendor presentation on a weight‑loss program (1-to-1) was deferred to old business for further review.
Consultants reviewing Sumner County’s self‑insured plans told the Self Insurance Board Committee that prescription drug spending — and particularly specialty medications — has become the largest driver of rising claims, and that a relatively small non‑preferred enrollee population showed steep year‑to‑year increases.
The consultant noted a Rx rebate hit in January that temporarily improved month‑to‑month cash flow, but cautioned the board that per‑employee‑per‑month…
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