Editor's note: This is the second in a two-part series about the university's efforts to address millions of dollars in health care cost overruns.
Ball State, seeking to make up a $7.5 million budget shortfall caused by rising health expenses, is raising health insurance prices for employees by as much as $67 per month.
The deficit has been caused by an increase in claims mostly related to high blood pressure, obesity and stress, according to public records obtained by the Daily News.
In the 2011-12 school year, medical claims were $4.2 million higher than projected, and most of the cost came from having more major and catastrophic claims than expected.
Chronic medical conditions - illnesses such as diabetes that continue for years - make up a sizeable part of the school's rising health care costs. Ball State uses third-party companies like Key Benefit Administrators, Inc. to help manage coverage of employees with those conditions.
"There's a fine line where employees don't want their employer to meddle in their health too much," Howard said. "But we certainly want to make sure we're offering tools and coverage that will help people manage their chronic conditions."
In each of the university's three health care plans, there is specific coverage to help with these conditions, including things such as a Chronic Disease Management Program and a waiver for the deductible on physician office visits for treatment of chronic diseases, and lab and electrocardiogram services.
Surgeries and medical supplies to treat obesity and weight loss are not covered. However, the university continues to work with third-party health care specialists to assess the costs and benefits of adding various types of coverage to its plans.
Assessments include benchmark analysis regarding health coverage options provided by other entities, as well as a campus-wide benefits survey, which will be administered in the Fall Semester. The survey will provide an opportunity for employees to have input regarding benefits the university offers. The results of the survey would then be utilized as one tool to help guide the university's future decisions on coverage.
Among employees with chronic conditions, the most common were high cholesterol, hypertension, asthma, hyperthyroidism and diabetes, according to records provided by the university. Most of these conditions can be treated with drugs, but some employees argue that more aggressive treatment - bariatric surgery to combat obesity, for example - should also be covered.
Tammy Edwards is a secretary in the Department of Modern Languages and Classics and has been battling Type 2 diabetes for the last couple years. She has tried without success to get insurance coverage for a bariatric weight-loss surgery that she said would cure her diabetes.
"I've been told I'm going to die within the next two years if I do not have an invasive surgery performed," Edwards said.
She said the university chipped in about $28,000 last year for her medication instead of paying a one-time amount of $25,000 to $30,000 for a gastric bypass operation.
In such cases, third-party entities such as Key Benefits decide whether a service would be the best response to a health condition.
"To be honest, that's what we try to do," Howard said. "As with any controversial topic such as health care, sometimes there [are] differing opinions as to what is or isn't best practice. And that's where to some extent we have to back off and let the folks that know a lot more about medicine than I do make the decisions that, 'Here's what you should or shouldn't cover.'"
On Feb. 22, Edwards posted an email appeal to faculty asking if they would like to see the university offer weight loss supplies and services covered by insurance. The message was quickly deleted from the university's Communications Center bulletin board. But even in the short time it appeared, Edwards said, almost 50 people responded - all but two supporting her position.
A note to Edwards from the Communications Center staff advised her, "The Communications Center is not the appropriate channel of communication for soliciting inquiries about additions to employee benefits."
Edwards was encouraged to relay her concerns through the university governance system, which includes the Staff Council. After the response her email generated, she felt compelled to pursue the issue.
"I can't let down those other people who were ... saying, 'Please try to figure out how to help us,'" Edwards said.
During a Staff Council meeting on March 15, Edwards asked again about bariatric surgery. In response, the school re-issued a 2008 memo from Marie Kavanagh, director of Payroll and Employee Benefits.
Kavanagh's note said the decision is based on cost and outcome.
"Gastric bypass surgeries are expensive, with an average cost being around $45,000," she said.
"There are also related costs if there are complications or if cosmetic surgery is needed for those individuals who have excess skin as a result of weight loss."
Instead, Kavanagh said she would like to focus on promoting healthy habits through programs like Working Well.
ENCOURAGING EXERCISE
Employees are showing some initiative already. In 2011-12, almost 800 benefits-eligible employees attended educational classes such as Weight Watchers, chronic disease management and nutrition counseling. More than 400 employees participated in biometric health screenings - a 58 percent increase from last year. And more than 500 employees completed an annual health survey - a 68 percent increase.
Terri Manring, program specialist for the Correctional Education Program, might be the model of the new Ball State employee whose lifestyle choices help control health costs.
Almost every day at lunchtime, Manring goes to Ball Gymnasium to work out, using the elliptical machines or lifting weights. Sometimes, she takes fitness classes over at the Student Recreation and Wellness Center.
"I gained a lot of weight over 10 years and now I'm working on losing that weight," she said recently during her workout.
With the help of protein shakes, she has already lost 17 pounds and 24 inches in three months.
Howard said he knows changes to the health care budget could mean a strain on personal finances, but he has tried to make reasonable decisions.
"If you look across the nation, wellness has got to be a [priority]," he said. "Health care costs can't keep growing at the same amount they're growing."
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