Employers are the health-care customers

By JIM LANDERS

Most of us have health insurance as an employee benefit. Your company shops around, tailors a package to suit what’s needed, offers it to the workforce and bears most of the cost.

Hospitals and physicians, meanwhile, talk all the time about putting patients first. While that’s reassuring, it also represents a significant disconnect in American-style health care. You need to know your customers if you want to run a business. And the customer is the one who pays.

The Dallas Fort Worth Business Group on Health represents 145 of the area’s biggest employers. As such, they are the area’s biggest health care customers.

As health care costs soared, the group’s members squeezed and trimmed their plans to the point where employees now bear 41 percent of the cost. They’ve pressed the health care establishment for better service and tried to coax their employees to take better care of their own health.

“We’ve always focused on the quality improvement rather than the cost side,” said Marianne Fazen, executive director of the group.

David Toomey, the Dallas-based regional president of health insurer Cigna HealthCare, is shaking this up. He’s urging Dallas employers and medical providers to come together in a North Texas health care summit this fall with a study showing Dallas is a big spender.

“That was a wake-up call for a lot of our board members, to see that kind of data,” Fazen said.

In other parts of the country, health care’s big customers are bearing down on the medical establishment. Boeing, Starbucks, Costco and other major employers pushed hard on hospitals in the Seattle area to put cost efficiency into their programs — and to remember who pays the bills.

Hospital administrators in Dallas hail their commitment to quality and have accolades to show for it.

Redefining quality

In Seattle, the employers paying for the care had a different definition of quality, said Bob Mecklenburg of Virginia Mason Medical Center, an organization of primary and specialty care clinics and a hospital. Worker absenteeism was hurting companies. They wanted their employees to be seen as soon as possible and returned to the workforce.

“Waiting increases the cost of production, so rapid access is important. And that doesn’t show up on a doctor’s radar screen,” said Mecklenburg, medical director of the organization’s center for health care solutions.

Third, employers wanted 100 percent patient satisfaction.

“Some of our retailers here have that ethic. Anything short of that for health care providers is certainly not what they would consider great satisfaction,” he said.

Fourth, Mecklenburg said, the employers wanted their workers to get the care they needed, but not more than that. Do what works to make the patient well: “That’s evidence-based care.”

Finally, the employers wanted the cost of care to come down.

“They didn’t want to spend the least amount. They wanted to spend the right amount,” Mecklenburg said.

Working together with employers and insurance companies, Virginia Mason changed its treatment approach for ailments like back ache, migraines and heartburn and wound up spending substantially less money.

Toomey, who worked with Aetna in Seattle when Virginia Mason and its customers tackled these issues, is hoping for the same result in Dallas.

X Jim Landers is a columnist for The Dallas Morning News. Distributed by McClatchy-Tribune Information Services.