Sunday, May 18, 2008

Employer - Straight Talk with a Corporate Medical VP

Recently I ran across this statistic: 60% of health coverage is employer-based and 30% is government-based. This struck me. I felt government was on the verge of taking over, mostly because employers can’t keep up with health cost inflation, which has been 4.4 X of health inflation vs. general inflation. Yet I know employers are reluctant to accept government-regulated cae.

So I called a lifelong friend, formerly the VP for medical affairs of a major multinational corporation. He prefers to remain anonymous. He’s an internist who wrestled with health inflation demons for 13 years during his corporate life.

I asked him, how can Corporate America subdue the inflation beast?

Here are his answers, none of which are easy to do.

1) Overcome the entitlement mindset. He claims Health Resources departments think of themselves as dispensers of health care entitlements rather guardians of cost.

2) Manage care rather than finance it. Too often, he says, corporations simply pay for efficient use of unnecessary care.

3) Treat health care as simply another product: deal only with providers who comply with product specifications. Quality first saves money.

4) For major illnesses, contract with major institutions with known outcomes. Again quality first saves money.

5) Institute wellness and prevention programs. Focus on screening and controlling those things – BP, glucose, and weight – known to have adverse outcomes.

6) Pay only for evidence-based care, based on evidence generated from the medical literature and from specialty societies: reduce excessive care.

7) Be aware of consumer-driven care and shared consumer-cost responsibility but do not rely on them. Employers will be wary of intrusions into their financial and lifestyle worlds and are difficult to inform and educate about proper care.

8) Have the CFO, who is responsible for the corporate bottom-line, engage directly in conversations with local and national physician organizations to set standards to see what else can be done rather than going through the current chain of health care command -- HR departments, HMOs and PPOs, and health care consultants.

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