Transforming Health Care

Transforming Health Care

Publication Date: March 29, 2019

Half of Americans get their health insurance through their employers, costing companies nearly $700 million a year. Yet the quality of care varies widely. Businesses are fighting back by skirting insurers and contracting directly with providers. In “How Employers Are Fixing Health Care,” Lisa Woods (senior director of strategy and design for U.S. benefits at Walmart), Jonathan R. Slotkin, MD (director of spine surgery at Geisinger’s Neuroscience Institute), and M. Ruth Coleman (founder of third-party administrator Health Design Plus) report on Walmart’s Centers of Excellence programs. These cover the cost of care for certain episodes (often surgeries) at carefully vetted partner providers, usually including travel costs. They have saved Walmart and its employees tens of millions of dollars while yielding superior outcomes: shorter hospital stays, lower readmission rates, less need for aftercare, and faster return to work than under traditional plans. How might a company set up such a program? Jonathan R. Slotkin, MD, Nancy Jester (senior manager of Centers of Excellence programs and a senior manager of strategy and design for U.S. benefits at Walmart), Lisa Woods, and M. Ruth Coleman lay out a step-by-step plan in “Inside Employers’ New Health Care Playbook.” In “Why Do Employers Provide Health Care in the First Place?” Melissa Thomasson (Julian Lange Professor of Economics, Farmer School of Business, Miami University) explains the history behind the costly and employer-centric U.S. health care system. One way to understand how Walmart’s Centers of Excellence program differs from traditional insurance is by looking at patient experiences. “Two Surgeries, Two Outcomes” features a timeline that compares two fictional Walmart employees undergoing spine surgery. Finally, in “What Makes Geisinger’s Destination Care Program Tick,” HBR’s Gardiner Morse interviews Geisinger interim CEO, Dr. Jaewon Ryu, about the benefits of Walmart’s program from the provider point of view.

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Transforming Health Care

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