Cracking Health Costs
John Wiley & Sons Inc (Verlag)
978-1-118-63648-0 (ISBN)
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.
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.
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
| Erscheint lt. Verlag | 9.8.2013 |
|---|---|
| Verlagsort | New York |
| Sprache | englisch |
| Maße | 158 x 231 mm |
| Gewicht | 386 g |
| Themenwelt | Wirtschaft ► Betriebswirtschaft / Management ► Personalwesen |
| ISBN-10 | 1-118-63648-1 / 1118636481 |
| ISBN-13 | 978-1-118-63648-0 / 9781118636480 |
| Zustand | Neuware |
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