Municipal workers are rushing to emergency rooms so much — 74 percent more often than expected — that the city is tripling the co-pays for such visits from $50 to $150, officials announced Friday.
Anyone who is actually admitted for emergency-room care wouldn’t have to pay.
Co-pays under the plan used by 75 percent of city workers are also going up for urgent-care visits — from $15 to $50 — because workers are utilizing them at a rate that’s 106 percent higher than at well-managed health plans.
The fees are part of a plan to encourage preventive and primary health-care visits by the city’s 300,000-plus municipal workers.
It’s why co-pay rates for preventive care visits and procedures are being cut to $0 under the plan.
“We continue to offer an extraordinarily good paid-in-full health program for city workers and I believe the changes that we’ve made will incentivize better use of care,” Bob Linn, head of the city’s Office of Labor Relations, said at a City Council hearing.
City officials said the changes would generate $150 million in annual savings starting July 1.
As part of its contract deals with labor unions, the city has committed to identifying $3.4 billion in health-care savings through fiscal 2018 — including $700 million this year and $1 billion next year.
Council members were upset to learn on Friday that the city missed this year’s target by $58 million — and that it is plugging the hole with money from a Healthcare Stabilization Fund that legislators said wasn’t intended for that purpose.
“That was never the intent . . . If this fund is going to be used for something different then it should be identified as that and there should be a transparent process,” said Council Finance Committee chair Julissa Ferreras (D-Queens).
“To call that a budget savings is, we believe, a far stretch.”
Budget watchdogs gave the city credit for its incentive programs but also took issue with how officials accounted for the savings.
Maria Doulis, vice president of the Citizens Budget Commission, noted that $622 million of the projected $1 billion savings next year was achieved simply by projecting that health-insurance premium rates would climb higher than they actually did.
“We would call the savings from the premium rates and tapping the stabilization funds accounting gimmicks,” she told reporters. “They’re certainly not changing the trajectory of health-care costs.”
Linn argued that using Healthcare Stabilization funding saved the city money because it can be used only with union approval.
His office said the city has pumped an average of $600 million to $700 million into the fund in recent years, as part of a decades-old labor agreement.