and I will continue to debate and argue over the best methods for lowering overall costs in the years ahead, but John’s heart is in the right direction. What he is looking for is what every CEO should be focusing on—how do we improve the health status of our workers while improving the cost and quality of health care services. I look forward to the thought-provoking discussions, and his readers will enjoy a thought-provoking book.”
—WILLIAM D. PETASNICK,
President and CEO, Froedtert & Community Health and
Former Chair of the American Hospital Association
“Serigraph’s focus, organizational commitment, and collaboration with its health plan administrator, Anthem Blue Cross and Blue Shield, and providers of value in health care proves that there are innovative solutions for getting the hyper-inflation in health care under control. It’s not a blame game; it’s about individual engagement, transparency, and effective management.”
—STEVE MARTENET,
President of WellPoint Specialty Products and
Former President of Anthem Blue Cross and Blue Shield in Wisconsin
How Companies Across America Are Dramatically Cutting Their Health Care Costs While Improving Care
John Torinus Jr.
BENBELLA BOOKS, INC.
DALLAS, TEXAS
Copyright © 2014 by John Torinus Jr.
All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles or reviews. Portions of this work have appeared in the e-Book Opt Out on Obamacare, Opt Into the Private Health Care Revolution, by John Torinus, released in 2013 by BenBella Books, Inc.
BenBella Books, Inc.
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Dallas, TX 75231
Send feedback to [email protected]
First e-book edition: April 2014
Library of Congress Cataloging-in-Publication Data
Torinus, John, Jr., author.
The grassroots health care revolution : how companies across America are dramatically cutting their health care costs while improving care / by John Torinus.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-939529-72-5 (trade cloth : alk. paper)—ISBN 978-1-939529-73-2 (electronic)
I. Title.
[DNLM: 1. Health Benefit Plans, Employee—economics—United States. 2. Costs and Cost Analysis—economics—United States. 3. Health Care Reform—economics—United States. 4. National Health Insurance, United States—economics—United States. W 275 AA1]
RA412.3
368.38'2—dc23
2013041457
Editing by Debbie Harmsen
Proofreading by Rainbow Graphics and Greg Teague
Cover design by Ted Mauseth
Jacket design by Sarah Dombrowsky
Text design and composition by John Reinhardt Book Design
Printed by Bang Printing
Distributed by Perseus Distribution
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The march is on to a new business model for the delivery of health care in America. Actually, it is a race. This book is dedicated to the innovators, most of whom are in the private sector, who are putting the pieces into place for that disruptive model. Health costs are the biggest economic issue facing the country. So these innovators—many are featured in this book—are doing patriotic work. They are fixing a broken, unsustainable model.
CONTENTS
1 GO OR NO-GO UNDER OBAMACARE?
2 PRIVATE PAYERS FORGE DISRUPTIVE NEW BUSINESS MODEL
3 THREE-YEAR GAME PLAN CAN FLATLINE COMPANY HEALTH COSTS
4 SELF-INSURANCE: COMPANIES KEEP THEIR HEALTH SAVINGS
5 CONSUMER-DRIVEN: COMPANIES ENGAGE EMPLOYEES
6 TRANSPARENCY: ENTREPRENEURS SHINE LIGHT ON PRICES, QUALITY
7 CENTERS OF VALUE: COMPANIES MOVE BUSINESS
8 RESTRUCTURED PRICING: COMPANIES DEMAND BETTER MODELS
9 ON-SITE CLINICS: COMPANIES TAKE OVER PRIMARY CARE
10 CHRONIC DISEASES: COMPANIES GO WHERE THE MONEY GOES
11 HEALTH AS ASSET: COMPANIES COME TO NEW UNDERSTANDING
12 OTHER PAYERS JOIN THE MARKETPLACE REVOLUTION
13 EMPLOYEES, EMPLOYERS, NATION: WIN-WIN-WIN
ACKNOWLEDGMENTS
ABOUT SERIGRAPH
TWO ENTIRELY DIFFERENT mind-sets are at work in the world of U.S. health care. The public and private sectors, which roughly split the nation’s nearly $3 trillion medical bill, see different challenges. Government leaders think reform means more access for more people through better insurance, subsidies, and expanded tax revenues; private companies see out-of-control costs as the main issue and improved workforce health as a major solution. The health care law that was signed into law in 2010 and has begun taking effect (with the full effect hitting companies in 2015) is all about access and insurance reform, but it leaves largely unaddressed the pivotal issue of costs, which have been spiraling upward for decades. The costs have about doubled every eight years.
In my first book, The Company That Solved Health Care, I described what my mid-size manufacturing company,