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Board approves one-year telemedicine contract after debate over savings and long-term costs
Summary
Winona County approved a one-year telemedicine/virtual care contract intended to reduce Blue Cross Blue Shield premiums, but commissioners raised questions about recurring costs, opt-outs and monitoring of utilization before the board green-lit the plan.
The Winona County Board voted on Nov. 4 to approve a one-year contract with a telemedicine and benefits partner presented by Todd Sellar, the county—s director of human resources.
Sellar said the program would reduce the county—s Blue Cross Blue Shield premium by roughly $120,000 while costing the county about $63,000, describing it as a net cost-reduction in the short term. "It is a $63 thousand dollar savings for us," Sellar said during the presentation, and he described contract terms as one-year with the ability to discontinue if outcomes do not materialize.
Several commissioners worried the program could become an ongoing expense if utilization or vendor pricing changed. "My biggest fear is we get started and we can't get off," one commissioner said, urging provisions for scheduled review and clear metrics. Commissioners also asked whether nurse practitioners and physician assistants would be able to prescribe medication through the service; Sellar said licensed advanced practice providers (nurse practitioners, physician assistants) would be in scope where appropriate.
Commissioner Olsen moved to approve the contract and Commissioner Meyer seconded. The motion carried after voice vote; one commissioner registered a dissenting vote during the roll call. Commissioners directed staff and the county—s insurance consultant to report back with monthly utilization trends and premium impacts so the board can reassess the program at the end of the contract year.
The board—s approval makes the program county-funded and obligates the county to monitor outcomes and premium data; commissioners urged clarity on opt-out rules for individual employees and whether the program would trigger bargaining obligations under union contracts.
