The City of Billings retained Gallagher Benefit Services (GBS) to assist in preparing and evaluating the City's Direct Network Contract for healthcare services resulting from a Request for Proposals (RFP).  The current contract with Rocky Mountain Health Network expires on December 31, 2019.  Proposals were solicited to deliver a direct contract solution to include the following services:

• Inpatient and outpatient services
• Lab services
• Professional provider services
• Anesthesia
• Injections/drug infusions
• Immunizations and vaccines
• Durable medical equipment
• Employee Assistance Program
• Occupational Health Services

Proposals, including pricing/cost information were sent directly to GBS, and not to the City.  Organizations who responded to this RFP were directed to submit proprietary or confidential financial information to GBS directly.  Billings Clinic and Rocky Mountain Health Network agreed, by signing, to certify not to request or share any proprietary or confidential, financial information, fee schedules, or reimbursement rates.

As part of the evaluation process, GBS instructed Employee Benefit Management Services (EBMS), the City's Third Party Administer, to reprocess all 2018 claims using each organization's proposed 2020 fee schedule, and to present the results to GBS directly.

On June 4, 2019, The City's Health Insurance Committee met with GBS to discuss the proposals.  Both proposals were evaluated by the Committee based on the following criteria:

• Organization's demonstrated breadth of services and quality considerations.
• Network access and member disruption needs.
• Strength of proposed reimbursement arrangements.
• Completeness and responsiveness of the organization's proposal in meeting the City's needs.
• Transition plan.

GBS presented information regarding the proposals to the Health Insurance Committee.  The committee engaged in a lengthy discussion and the vote was finalized on June 5, 2019, resulting in Rocky Mountain Health Network being awarded the contract, pending City Council approval. The contract is effective January 1, 2020 to December 31, 2024.  The contract may be extended for up to five additional years by mutual, written agreement.



 

City Council may:

• Approve, or;
• Disapprove the Direct Network contract.

The current 8-year agreement with Rocky Mountain Health Network resulted in savings for both the City and its employees.  The health insurance premium history over the past 8 years follows:

• 2012 - No increase
• 2013 - No increase
• 2014 - No increase
• 2015 - No increase
• 2016 - Decrease in premiums
• 2017 - Increase in premiums back to 2015 rates
• 2018  No increase
• 2019  No increase

Staff recommends approval of the Direct Network contract with Rock Mountain Health Network, which includes the majority of St. Vincent Healthcare affiliates, as recommended by the City's Health Insurance Committee.