County explores HERO wellness program as health claims push insurance costs up

Washington County officials reviewed employee health insurance activity and described a new HERO program aimed at reducing long‑term drug spending for employees with type 2 diabetes.

The insurance director reported recent stop‑loss reimbursements and pharmaceutical rebates helped the fund in the short term but noted substantial rate pressure from higher hospital reimbursements and specialty drug costs. "We had about a quarter million dollar specific stop loss reimbursement," the director said, and identified pharmaceutical costs and hospital recontracting as major drivers of premium increases.

To address chronic‑disease costs, the county is offering the HERO program: participants may receive GLP‑1 medications with a copay reduced to $0 while they participate in a structured two‑year support program of monthly meetings with a dietitian, nutritionist and a neuroplasticity coach. The director summarized program goals: "The HERO program... takes their copay from $50... down to $0" and the success measure is coming off GLP‑1 within two years and maintaining an A1C under about 6 for six months.

Members questioned how participants qualify and how success is measured; staff said standard industry preauthorizations and A1C metrics apply. Officials said the program could save employees roughly $600 per year on GLP‑1 drugs and potentially reduce future high‑cost events that drive premiums.

Next steps: Staff will continue program implementation and answer follow‑up questions from JPs by email and future reports; the committee noted the program is voluntary and success measurements are A1C and sustained medication tapering.