OnSiteClinics.Org

The Company that Solved Health Care?

A Book Review:  “The Company That Solved Health Care”, Torinus, John Jr., Benbella Books, Inc.  2010

The book is about SERIGRAPH which is a Wisconsin based printing specialty products firm.  They took a giant leap forward in managing the healthcare and costs for their employees under the direction of Mr. Torinus, the author and the owner of Serigraph, since 1987.  He is currently the Chairman of this graphics parts manufacturer, which is based in Wisconsin (it seems to us that Wisconsin is really the epicenter of innovation and improvement in employer-managed health care!).

Mr. Torinus has taken a firm and directive approach to solving the problems his company faced (and continues to face) with rising healthcare costs.  He put his employees right in the middle of the battle, and together they are making giant steps forward.  It all began in 2004 (only six short years ago), and the project has continued and expanded over time to become a huge success.  Why?  He overwhelmingly supports key pillars of his approach:

(1) Use consumer-driven health plans that put employees in charge of their health care and their health care dollars; (2) Get transparency in pricing – a truly tough assignment as all of us know, but Mr. Torinus has proven it can be done.  His company has information available on line and through their H.R. offices for employees that is detailed and compares pricing and quality for major procedures and providers.  By using this resource, employees can not only save money but get better quality too.  His staff have worked hard to understand pricing for major/high volume services and given that information to staff.  They have also designated “Centers of Value” – providers who not only offer better pricing but have demonstrated high volume and high quality in what they do.  (3) Use primary care as a central component to help keep employees well and out of the hospital. (4) Fight for consumer regulations which make more quality and pricing data available to the general public.

The most important point is that his approach works.   By 2009, the Serigraph employees and their dependents’ data showed that inpatient admissions were 23% below the norm for the U.S. and that E.R. visits were 39% below the same norm.  Total cost/employee annually was $6,648 compared to $8,659 nationally.  (The source of the national data was not provided, but obviously they benchmark!)

What do we think after reading the book?  Well, this is a model that is truly employer-managed, however, it has an extremely limited approach for primary care and on-site management.  The staff on-site has been a nurse practitioner until 2010 when Serigraph contracted with a physician to provide limited services on-site (one-half day/week).  This physician is paid a flat fee/patient who is then provided global primary care services for the year.  The physician becomes that patient’s primary care physician, providing an extremely high level of service including longer visits, management of all other services to the patient, telephone calls, etc.

So, the on-site clinical services have played a relatively small role in achieving the savings the company has fostered.   This is really a “consumer-driven” approach to health care, with Mr. Torinus and his employees taking charge of the process and identifying confusion, pricing problems, etc.  The incentives are focused on helping employees make better decisions about how the health care dollar is spent, perhaps somewhat less on global health management and wellness.   However, Torinus does play up the “value” in value based contracting and the “care” in care management.  His ideas should resonate with many on-site managers.  (For additional reference to these same ideas, check out LaPenna’s book chapters on the same subject area in Google “books”.)

What we believe is that this strong focus on controlling costs and improved decision-making works – but it would work even better if combined with a strong on-site clinic with comprehensive primary care services.   You can obviously achieve great things through this method, but combining this with an on-site clinic is bound to work better.

We applaud Mr. Torinus for taking this bold approach, for his efforts to improve the health of his employees and their families, and the health of his company’s bottom line.  It is this type of “out of the box” thinking that brings innovation and success.  The book is well worth reading, even for those of you with established programs, we are sure you will walk away feeling you have learned something of value and it will confirm what many of the industry leaders are (and have been) doing.  The book makes ample reference to QuadGraphics and their success and it also references other experiences in describing “the possible”.