The Brookings Health System has raised concern of an agreement between the state and Sioux Falls hospitals to provide Tier 1 services for full coverage to state employees, but only at the approved facilities.
Tier 1 procedures cover five areas: orthopedic, cardiac, gastroenterology, bariatric and renal care. State employees that decide to have Tier 1 procedures conducted at a non-Tier 1 facility such as the Brookings Health System will pay large out of pocket expenses. With the Brookings population consisting of over 4,000 state employees, Brookings Health System CEO Jason Merkley feels the agreement will affect the hospital negatively.
“A fifth of our population in Brookings is underneath the state employee health plan,” Merkley says. “So when you start to direct people outside of your community, it has a direct relationship on the Brookings Health System impact financially. But I would go further than that and it’s actually an economic development issue.”
Merkley says the Brookings Health System is a city-owned hospital and can’t compete with the Sioux Falls facilities that have agreements with the state. The hospital is seeking support from the Brookings City Council on the issue.
According to Laurie Gill, Commissioner for the Bureau of Human Resources, the contracts made with the Sioux Falls facilities will save tax payers money.
“They are procedures that are not routine, but can be complex and high cost,” Gill says. “By doing that, by going in and negotiating and enter into specific contracts as I said, the goal was to save the state health plan and the state taxpayers money.”
Gill says that in the previous year, the only Tier 1 procedure conducted on state employees at the Brookings Health System was gastroenterology. Gill says the state will continue to work with the Brookings Health System on the issue.