One of the biggest drivers of municipal budgets each year is the rapid rise in annual health care costs. In an attempt to slow this rising expense, Manchester officials are asking employees to pay more for their insurance, take better care of themselves and go to less expensive doctors.

Last fiscal year, Manchester paid a total of $44 million in health insurance claims. Of that, $19.5 million was on the city side, a 16 percent increase from the previous year, according to information from Anthem Blue Cross Blue Shield New Hampshire. The city paid out about $6,000 per member last year, which includes employees and their families. This amount is 14 percent higher than the norm for Anthem customers in New Hampshire.

The city of Nashua, by comparison, paid out $25 million for employee health insurance. Nashua's health care costs rose about 6 percent last year. A projected 11 percent increase was avoided by implementing health care changes that included a 10 percent increase to premium-cost sharing and changes in plan design that introduced deductibles and slightly increased co-pays.

According to Anthem, Manchester offers a very robust plan and pays a higher percentage of their employees' health insurance benefits than any other city or company in Anthem's New Hampshire book of business.

These statistics are why the city pushed so hard to get concessions on health care costs from unions this year. These concessions have freed up millions in vital funds during the city's first budget under the tax cap, but officials are still looking for ways to manage rising costs in the long term. Officials are also looking to programs that encourage employees to live healthier and shop for better deals for common medical procedures.

Making choices

An Anthem study of city employee insurance claims last fiscal year showed that 25 percent of emergency room visits could have been treated in another setting and 52 percent of claims were related to lifestyle issues, including overeating or smoking.

In Nashua, programs were started to address some of the issues that contribute to increased health care costs. An annual wellness fair provides city employees with a variety of information on diet and healthy living. Cholesterol testing, blood pressure reading and other screenings are available at the event.

Lunch and Learn events educate people in an informal setting. Walking programs and a program that contributes to the cost of joining weight watchers are two more services offered in Nashua to address specific concerns.

Manchester hosts annual health initiatives to get employees to exercise more, and for the past two years it has offered employees cash incentives through the COMPASS Smart Shopper if they opt to go to a less expensive provider for more than 40 common procedures whose costs can vary by thousands of dollars.

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Taxpayers share burden of health care costs