Jacksonville committee hears plan to curb rising city health‑care costs; Bailey Group to analyze pharmacy, stop‑loss and contribution options

The Jacksonville Doge Committee on Oct. 7 heard a presentation from the Bailey Group on steps to reduce a multi‑million‑dollar shortfall in the city’s self‑insured employee health plan and on how the city might limit future increases in health‑care costs.

The Bailey Group, a benefits consulting team affiliated with NFP and Aon, told the committee it will gather two years of claims data to analyze pharmacy management options, stop‑loss coverage, medical repricing and contribution strategies. "I view this as a as a 3 year plan," Councilman Ron Salem said, adding the goal is to identify both short‑term changes and longer‑term actions the administration could adopt.

Why it matters: City officials told the committee the health plan has faced a structural gap between premiums and claims. Committee chair Ron Salem said prior budget actions had covered more than $28 million in recent years to shore up the health care trust; the Bailey Group presentation emphasized that pharmacy spending and large individual claims are major drivers of rising costs.

Key points from the presentation

- Pharmacy strategy: The Bailey Group explained the difference between a "carved‑in" pharmacy arrangement (managed by the same carrier that handles medical claims) and a "carve‑out" to a dedicated pharmacy benefits manager (PBM). The firm presented de‑identified case studies in which a formal carve‑out or contract renegotiation…