Health Care Costs – 3 Ways to Cut Them Right Now Catherine Arnst describes 10 ways to cut health care costs right now. Three of those measures that are currently being addressed by Kaiser Permanente are: cracking down on fraud and abuse; developing a healthy workforce; and stopping infections in hospitals. As researchers and Kaiser Permanente itself have shown, these steps have significantly reduced related health care costs. Nevertheless, there are still some incidents of fraud/abuse, unhealthy lifestyles and hospital-induced patient infections that pose a drain on health care dollars. Consequently, as a manager, I would develop programs along the same lines but would add monetary incentives for compliance in order to achieve an even higher incidence of compliance while rewarding health care professionals/employees for compliance with those programs. The addition of systematic monetary incentives should cut costs even further while enhancing employees' physical and financial wellness.
Health Care Costs
Ways to Cut Them Right Now
In the face of high health care costs, the health care industry is striving to reduce costs by addressing chronic, expensive drains on health care dollars. Researchers have offered numerous steps that can be taken to significantly reduce costs. Furthermore, while some cost-cutting programs are considered ineffective window-dressing, major health care providers have systematically and pointedly taken successful steps to reduce costs while rewarding compliance with those steps.
Three of the Ten Ways to Cut Health Care Costs Right Now, Described by Arnst
While Catherine Arnst describes 10 ways to cut health care costs right now and Kaiser Permanente addresses all 10 of those ways, 3 of the ways Kaiser Permanente cuts health care costs leap to mind: cracking down on fraud and abuse; developing a healthy workforce; and stopping infections in hospitals. "Fraud and abuse" in health care includes but is not limited to phony medical claims, kickbacks to health care providers and concocted payment schemes (Arnst, 2009). According to Arnst, due to law enforcement crackdown in other areas, organized crime has entered the lucrative business of health care fraud and abuse, with a low estimated yearly cost of 3 -- 10% of all health care spending for fraudulent billing alone (Arnst, 2009). Consequently, health care institutions are now focusing on detecting and eliminating as much fraud and abuse as possible. "Developing a Healthy Workforce" in Health Care involves a health care institution's offer of wellness services to employees, based on the theory that "prevention pays" (Arnst, 2009). In support of this theory, Arnst quotes Dr. Fikry W. Isaac, Johnson & Johnson's executive director of global health services, who states: "Seventy percent of health-care costs could be prevented through lifestyle modification" (Arnst, 2009). Despite the wisdom and savings inherent in overall wellness services, prevention is too often overlooked (Lavizzo-Mourey, 2009, p. 1). In an effort to address that neglect, some companies offer services such as smoking cessation classes, online weight loss and stress management tools and fitness centers to their employees (Arnst, 2009). In addition, some health care institutions couple wellness services with incentives such as reduced health insurance premiums to encourage as much employee participation as possible (Arnst, 2009). Finally, "stopping infections in hospitals" entails establishing and enforcing protocols to reduce the contamination that infects 1.7 million hospital patients per year and kills 99,000 of those patients, reportedly adding $30 billion per year to America's health care costs (Arnst, 2009). Adopting a "zero tolerance" policy toward hospital-induced infections, developing and enforcing common-sense checklists, and the Keystone Project aimed at eliminating catheter-related infections are all methods being employed by health care institutions to severely reduce/eliminate contamination and related health care costs (Arnst, 2009). In addition, Venessa Wong's slide show highlights Mission Memorial Hospital's screening and isolation of patient's with staph infections, reducing the hospital's staph-related expenses $925,000 in 2008 (Wong, 2009). Clearly, at least some health care institutions are decisively cracking down on fraud and abuse, developing a healthy workforce and curbing/stopping infections in hospitals, with significant health care cost reductions.
The Ways in Which Kaiser Permanente is Actively Addressing those Three Ways to Cut Costs in Terms of Improving Their Health Care Delivery
Kaiser Permanente is one major health care institution that is deliberately cracking down on fraud and abuse, developing a healthy workforce and curbing/stopping infections in hospitals. Kaiser Permanente maintains that "fraud occurs when someone misrepresents the truth to get a benefit or advantage" and that "abuse is the wrongful or improper use of Kaiser Permanente or government resources" (Kaiser Permanente, 2012). Kaiser Permanente requires four steps of its employees to combat fraud and waste: do not participate in those activities and if you suspect that someone else is engaging in fraud or abuse, report it to a manager/supervisor, steward, union rep, compliance officer or Human Resources rep or make an anonymous report by calling 1- [HIDDEN] ; follow the institutions code of conduct, as well as all policies, laws and regulations; avoid conflicts and the appearance of conflicts between your interests and those of Kaiser, and report any possible conflicts to a manager or compliance officer; carefully any documents you are required to sign, ensuring that the information is correct and complete, that you are the correct person to sign and that the date is correct (Kaiser Permanente, 2012). In order to address the ongoing wellness of its employees, Kaiser: engages in a Labor Management Partnership with employee unions to promote and provide healthy lifestyle resources, such as a "Total Health Assessment" questionnaire so an employee can determine the correct wellness plan for himself/herself and a series of 10 online "Healthy Lifestyle Programs" to address insomnia, stress, smoking cessation and weight loss (Coalition of Kaiser Permanente Unions, 2012); Kaiser also maintains a Healthy Workforce Gateway that provides "good health resources and tools" to employees according to the regions in which they work (Kaiser Permanente, 2008). Finally, Kaiser proactively addresses possible patient infections in hospitals by developing "clear and concise protocols" based on the ideal of "unrelenting focus" and "patient-focused standardization of practice" for a high quality of care. These protocols have significantly decreased deaths by sepsis in KP-controlled/owned hospitals (Kaiser Permanente, 2011). In specifically and assertively addressing fraud/abuse, employee wellness and reduction of infections among hospital patients, along with other methods, Kaiser has proactively enhanced its practices while noticeably cutting health care costs.
The Ways in which I, as a Manager, Would Address These Three Points When Planning New Programs or Services
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