The Care Continuum Alliance has released three addendums to its Outcomes Guidelines Report (Vol 5).  These address specific areas in wellness, prevention, and health management:  waste reduction, risk reduction, performance and productivity improvement, and how to apply the guidelines to an outcomes-based contracting framework. 

The guidelines and the addendums are available as free downloads.  I have not read through all the documents, but I have reviewed the addendums.  I encourage those of you who are working at the management level to take a look at the Outcomes Guidelines Report and then the addendums.  The addendums not only give you guidance and practical ideas/information, but they also provide specific case studies and research which support the options they offer.  

If hospitals, health clinics, and public health programs are laying people off, the dispossessed and disposed-of workers need only look to their nearest Walgreens (or any of the many employers expanding in the on-site industry).  Presently,  for nurse practitioners alone, Take Care has 46 open positions on their Web site .  

They also have a posting for the position of Medical Director at one of their Walgreen's distribution centers.  Obviously, this means that Take Care is practicing what they preach by providing for their employees the same type of services they are vending for others.  They are among a select group that deploys on-site services for their own employees and provides like services for other employers on a contract basis.  This group includes Quad/Graphics (QuadMed) and Cerner (Cerner Healthe Clinics).  Do you know of any others?  

With the advent of consumerism in health care, the implication is that consumers will become more informed and involved.  Mostly, they are only involved in the part that includes increased co-pays and deductibles.  They still seem to be uninformed about options and choices or the cost of those choices.

A recent article, reported in the Texas Tribune and referenced in a variety of news sources around the country (including the New York Times) shows the wide range of pricing for the same procedure hospital-by-hospital in Texas.  The authors have done some extensive research and given the reader an interactive tool for them to discover hospital pricing comparisons on their own.  This displays Medicaid costs for 17 diagnostic categories in dozens of Texas cities,  for individual hospitals.

This information is neat to look at in the abstract and is critical information for someone seeking medical care on a high deductible plan.  (Yes, hospitals are complaining that this is an unfair comparison.)

Quoting some examples:  "A routine delivery at St. Luke's The Woodlands Hospital costs twice as much as at Christus St. Catherine Hospital in Katy, just 50 miles away.  A coronary bypass?  The Laredo Medical Center bills Medicaid nearly $5,500 more for one than the Harlingen Medical Center."  (Author/editor Emily Ranshaw should be commended for her oversight on this piece.  I wonder if she wants a job working for a consumer affairs agency?) 

Employees are getting wise to this information, and employers need to take heed and get out in front of the trend.  This is the grist on which the health system will feed in the future -- information.  Can your company provide for your employees a simple tool similar to the one that is offered by the Texas Trib staff?  I would bet the answer is "no." If so, and you offer an on-site clinic, you are giving out primary care and access to service without access to information -- the consumer is being only half-served. 

This type of information has been a key component of the program at Serigraph, which has achieved remarkable results by engaging employees in making wise health care choices, both in terms of quality and price.  You might take a look at the book by Serigraph CEO, John Torinus, and his blog.  He provides some extremely valuable insight into how to find and use this type of information.