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Consultants say pharmacy review is producing "significant" savings; full health-plan recommendations due in June
Summary
Consultants from the Bailey Group told the Doge committee that they prioritized pharmacy analysis and medical repricing for the city's group health plan and expect a detailed pharmacy and contract update on Feb. 18, with further recommendations and final budget numbers by June.
The Doge oversight committee heard an update from the Bailey Group on the city's group health-plan review, with consultants saying early work points to substantial savings from the pharmacy benefit and repricing work.
"We are seeing significant savings in what's coming back," said Sabrina Abares of the Bailey Group, who with colleague Sherry Beignet outlined a five-part scope that includes pharmacy analysis, stop-loss review, salary-tier benchmarking and benefit-eligibility scrutiny. The consultants said they prioritized the pharmacy and repricing efforts because those items take longer to implement and will affect next year’s plan decisions.
The consultants set a schedule that calls for a Feb. 18 committee meeting focused on pharmacy results and contract review; medical-repricing follow-up in March; an April review of benefit-eligibility populations; and final actuarial budget numbers in June. They emphasized that stop-loss procurement must wait until sufficient claims experience is available so market quotes are firm.
Committee members pressed for an earlier timeline so findings can inform the FY 2026–27 budget process. "Ideally before October, preferably before September," said Council member Raul Arias, who asked that results be available to shape contribution and funding choices. Consultants and auditors said some analyses (notably stop-loss) require additional runout data but that most pricing and pharmacy findings will be available earlier in the cycle.
The presentation reaffirmed that any recommended changes — such as moving pharmacy to a different vendor or adjusting employee contribution tiers — would return to the council with concrete numbers and implementation steps. The Bailey Group and council auditors said they will provide actuary-driven budget figures in June to support any ordinance or budget amendments.
The committee scheduled the Feb. 18 update and asked staff and consultants to coordinate so the findings can be considered during budget deliberations.
The committee adjourned after discussing other agenda items; the health-plan review will return to Doge and to committee meetings in coming months.
