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Foxborough reviews options as municipal health insurance costs surge
Summary
Consultants from the Hill Group told the select board that municipal health insurance costs have risen sharply; the town issued an RFI to carriers and will evaluate staying with the MAYA pool, joining other purchasing groups, or using plan design changes and opt‑outs to contain costs.
Consultants from the Hill Group told the Foxborough select board on Feb. 17 that rising medical and pharmacy costs are a primary driver of increasing municipal budgets and that the town is actively evaluating alternatives to limit premium growth.
"Health insurance has been a very significant line item for communities across the Commonwealth," Danielle Chathlick, practice leader for the public sector at the Hill Group, told the board, as she outlined market forces including insurer consolidation, hospital financial pressures and the impact of specialty drugs such as GLP‑1 medications.
Mariana Gell, a senior consultant with the Hill Group, said Foxborough currently participates in a municipal pool (MAYA) that smooths volatility but that pool obligations can still lead to rate increases that exceed the town's own claims experience. The consultants said the town has released a request for information to regional and national carriers, and will evaluate fully insured and self‑insured options as well as participation in other joint‑purchasing groups.
Town staff and the consultants emphasized education and voluntary plan changes as short‑term levers. The presenters recommended continued promotion of the recently introduced high‑deductible health plan and the use of health savings accounts the town subsidizes, stronger enrollment education for active employees and retirees, and consideration of an employee opt‑out program when alternative coverage is available.
Officials presented numbers showing health insurance costs rising roughly 20% over three years, while overall town spending rose about 8% in the same period; presenters said health insurance spending grew from about $9 million in FY24 toward a projected $10.8 million in the current fiscal year, increasing the line item to more than 10% of total town spending.
Staff framed the study as due diligence rather than a commitment to change. "We don't know what will come out of this process," a member of the town team said, noting the RFI results and insurer renewals will guide whether Foxborough stays with MAYA or pursues other arrangements.
The presentation prompted questions from board members and one board member described a recent primary‑care billing that yielded an $800 combined charge for a physical and office visit, an anecdote raised to illustrate provider billing practices that feed higher plan costs.
The board did not take action on the Hill Group recommendations at the meeting. Officials said they will return with procurement results and renewal numbers in the coming weeks, and emphasized that any change would be evaluated for the town's budget impact and for employees who share a portion of increased costs under current contribution formulas.
