Charles County commissioners gave their consensus Sept. 15 to move forward with a dedicated primary care health center for county employees, a project officials say could save the county millions of dollars over the next five years without costing taxpayers anything upfront.
The center will be operated by Marathon Health, a national firm that has built more than 55 similar employer-sponsored health centers, under a model the county has been developing for years. Human Resources Director Alexis Blackwell told commissioners the project’s goal is straightforward: better, faster access to care for county employees and their families. “The real focus on it for us in the HR department is that it’s going to improve health outcomes for our staff,” Blackwell said, adding that the department wants employees “able to access immediate health care when they need it.”
The center will combine primary and preventive care, urgent care for minor injuries and illness, occupational health screenings for first responders and other job categories, on-site lab work, and dispensing of roughly 150 to 200 generic medications — all at zero out-of-pocket cost to employees, spouses and dependents enrolled in the county’s health plan. It’s expected to be open at least 40 hours a week, with commissioners retaining control over the specific hours and location to fit different employee schedules.
How it’s funded
The upfront cost comes with no new burden on county taxpayers. Charles County secured $900,000 through the Maryland Association of Boards of Education (MABE) — funding steered in part through state Sen. Guy Guzzone of Howard County — to cover startup costs, including build-out of a leased, existing facility (capped by contract at $700,000) and the medical equipment, staffing recruitment and training needed to open. County Fiscal and Administrative Services Director Jake Dyer told commissioners the county has also set aside roughly $3 million in fund balance reserves to help cover the facility’s lease payments in its early years, which would otherwise come out of the county’s self-funded health insurance plan rather than general tax revenue.
Ongoing operations will run on a flat monthly per-employee fee, projected at roughly $1.3 million annually including drug, lab and vaccination costs, covering all of Marathon’s staffing, insurance, marketing and reporting. Marathon representatives told commissioners the flat-fee structure is the mechanism for savings: as more employees shift from unpredictable “fee for service” claims — emergency room visits, urgent care, specialist referrals — into the fixed-cost health center, the county’s overall variable health spending should decline.
The numbers commissioners were shown
Based on 24 months of the county’s own claims data, Marathon projected the center would shift about 4.2% of the county’s roughly $21.4 million in annual health care spending in year one, translating to an estimated $897,000 in first-year savings. Projected over five years, that grows to about $12.3 million in gross savings, or roughly $5.3 million net after subtracting the center’s own costs — a figure that doesn’t include additional savings from the occupational health component.
Commissioner Gilbert “BJ” Bowling pressed Marathon representatives on accountability, asking what “skin in the game” the company would have in hitting those projections. Marathon said it would tie performance guarantees to patient engagement levels, patient satisfaction scores, clinical quality outcomes such as diabetes management, and the hard-dollar claims savings themselves. Bowling also raised the idea of steering any future healthy-food or wellness partnerships tied to the center toward local Charles County producers rather than outside vendors, framing it as both a health and economic development opportunity, and floated the idea of eventually passing savings back to employees through “premium holidays” — a benefit he said he’d seen used in Prince George’s County government. Staff cautioned against setting that expectation before the center’s actual savings materialize.
Commissioner Amanda Stewart asked whether the center would be available only to current Charles County government employees and their dependents, or open more broadly; staff confirmed it would initially serve county government employees, dependents and retirees enrolled in the county’s own health plan, though officials noted early conversations about potential partnership arrangements with Charles County Public Schools and with St. Mary’s County’s own existing Marathon Health center, given the number of employees who live or work across county lines.
Currently, 17 similar health centers operate across Maryland for counties, school systems and some private employers, with the model continuing to expand on both the Eastern and Western shores. County officials said the center will need roughly six and a half months to open once funding and site logistics are finalized, targeting an opening within the current fiscal year.
The Chronicle previously reported that commissioners had discussed the concept in earlier briefings; Tuesday’s session marked the formal presentation seeking commissioners’ consensus to proceed with implementation.
