It’s been a hot summer, and not simply outside. The temperature inside Town Halls across the country clearly boiled over and so did the tempers. And in the midst of all the summer follies, we seem to have forgotten the essential need for heath care reform. In a recent NEJM Perspective that I penned with co-authors Meredith Rosenthal from the Harvard School of Public Health and Michael Painter from the Robert Wood Johnson Foundation, we show the projected increase in health care costs for the private sector in the next decade, and the news is more than concerning. The status quo will result in $1 trillion being added on the shoulders of employers and employees, a veritable tide of red ink. That’s an extra $4,000 for every employee and for every dependent. Without a significant increase in productivity and/or revenue growth, most companies will experience flat or negative earnings because their profit per employee will be completely consumed by the increased medical costs. It is, very literally, a recipe for national disaster and it’s time to face it head on and take some serious action bend the cost curve.

We’ve recently developed a series of programs and tools to help employers take action now to stem this tide of red ink. First, you should know your numbers:

• How much money are you spending in potentially avoidable costs? As the NEJM Perspective specifies, these consume, on average about $2 out of every $10 you’re currently spending. Knowing that number and holding yourself, your employees, the delivery system and plans accountable for jointly reducing it will force massive change in the status quo. We can help you figure out your number.
• How many of your employees with chronic conditions are seeking care from BTE-recognized physicians? On average, these physicians save you at least 6% on the total yearly costs of care. That might not seem like a lot, but it sure helps in stemming the red ink. Increasing the number of BTE-recognized physicians is simple and our studies demonstrate that clearly. You need to get your plans to pay for results and recognition, not simply volume. You can also increase the number of patients going to recognized physicians by tiering your co-pays. We can help you design a strategy that will work for you.

Once you know your numbers, the rest is about operations and contracting. The good news is that all the health plans we work with are engaged in robust value-based purchasing, especially the ones we’ve endorsed. Know your numbers and take action. And don’t get distracted by the “follies” because they won’t stem the tide of your red ink. Only you can, and we can help you. 

Francois de Brantes, MS, MBA
Chief Executive Officer