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.
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 Deja 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