Cracking Health Costs: How to Cut Your Company's Costs and Provide Employees Better Care

ISBN-13: 9781118636480 / Angielski / Twarda / 2013 / 224 str.

Tom Emerick

Opis

Cracking Health Costs reveals the best ways for companies and small businesses to fight back, right now, against rising health care costs. This book proposes multiple, practical steps that you can take to control costs and increase the effectiveness of the health benefit. The book is all about rolling back health care costs to save companies and employees money. Working hand-in-hand with their employees, businesses need to ensure that, whenever feasible, employees with the most expensive diagnoses get optimal treatment at hospitals not practicing -volume-driven- medicine for higher profits. Less than 10% of employees incur 80% of costs. About 20% of patients have been completely misdiagnosed, while many others are simply the victims of surgeons who are either practicing bad medicine or overtreating for profit. For example, some companies, such as Walmart and Lowe's, are turning to the -Centers of Excellence- approach author Tom Emerick helped to pioneer while running benefits for Walmart. By determining which hospitals are adopting the highest standards of care, benefits managers can reduce the number of unnecessary high-cost surgeries and improve employees' overall health. The solution-based approach offered by the book is unique, because it can be implemented by businesses today.

Spis treści

Foreword David A. Rearick ix

Introduction xiii

PART I MOSTLY BAD NEWS 1

Chapter 1 Myths and Facts about Your Health Benefit 3

Chapter 2 Does Your Broker or Consultant Have Your Back? 25

Chapter 3 It′s Time for the Wellness Industry to Admit to Doping 39

Chapter 4 This Is Your Health Benefit on Drugs 57

Chapter 5 Your Employees′ Health Is Too Important to Be Left to the Doctors 69

Chapter 6 Are New Delivery Models Déjà Vu All Over Again, Again? 89

PART II MOSTLY GOOD NEWS 109

Chapter 7 The Company–Sponsored Centers of Excellence Model 111

Chapter 8 Hospital Safety: How to Get Your Employees Back to Work in One Piece 131

Chapter 9 Real Care Coordination: The Only Other Way to Save Money 145

Chapter 10 Goofus Retains a Wellness Vendor, Gallant Implements Well–Being 161

PART III WHAT SHOULD YOU DO NEXT? 175

Chapter 11 Health Insurance Exchanges: Should You Stay or Should You Go? 177

Notes 189

Bibliography 193

Acknowledgments 195

About the Authors 197

O autorze

TOM EMERICK is a leading expert in health benefits design, global healthcare challenges, healthcare economics, evidence–based medicine, and process improvement. Currently, he is the President of Emerick Consulting LLC. Tom spent fifteen years at Walmart, designing and managing benefits for over 1.6 million employees. He has held positions with Burger King Corporation, British Petroleum, and American Fidelity Assurance Company.

AL LEWIS, President of the Disease Management Purchasing Consortium, is widely credited with inventing disease management. Lewis is also the author of the award–winning Why Nobody Believes the Numbers (Wiley). He provides procurement and outcomes consulting to health plans and human resources/benefits departments, and administers the industry certification program in Critical Outcomes Report Analysis. He holds undergraduate and graduate degrees from Harvard, where he also taught economics.

Blurb

A simple solution exists for reducing your company′s healthcare costs: spend less money. Until now, we′ve been taught the reverse: spend more money today for the promise of an ROI later, one that is usually made up. Hence your costs keep rising due to massive overspending on diagnosis, testing, medication, procedures, and even prevention that in some cases actually harms your employees. Cracking Health Costs explains what you, as the executive responsible for your company′s healthcare spending, can do to slow this epidemic of healthcare–gone–wild, by spending less freely but more wisely on vendors, consultants, and providers.

You′ll learn:

• How businesses can help employees avoid specialists and hospitals driving volume for profit
• How benefits consultants and brokers inflate your healthcare spending
• How wellness actually increases your costs . . . and can even harm your employees
• Why PBMs are so profitable at your expense
• Why strategies emphasizing coordinated care and employee well–being succeed where wellness fails
• And much more

Cracking Health Costs offers unique solutions that your businesses can implement immediately, mostly at no cost. Start fighting back against healthcare costs, and start improving your employees′ health today.