“The Company That Solved Health Care” by Serigraph

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Rampant Health costs can be controlled

The inflationary rise in healthcare costs for employees and employers according to the experience of 2003 through to 2004 was a matter of serious concern especially because the healthcare bill was becoming unsustainable, a situation which could put to risk the financial health of organizations. Successive increases in healthcare costs of more than U.S $ 800,000 between 2003 and 2004 and other projected rises without the possibility of being controlled to competitive levels was an additional issue to contend with.

Because of the failure to tame the rising prices using traditional methods such as the wellness and fitness program, and other contingency countermeasures could not help to tame the runaway inflation. Given the background information and the number of companies experiencing similar runaway financial costs, many companies attempted to seek solutions by creating coalitions to enhance their buying powers of the resulting costs which had wiped out savings that could be made in the long term.

Many sessions that were held to address the problem of escalating costs produced a litany of excuses with the underlying rationale being that such healthcare costs were unstoppable. The key elements reinforcing the argument included the costs of providing healthcare for an aging population, new technologies, and trial lawyers. In addition, underpaid healthcare providers, high costs of executives and insures exorbitant doctors, high costs of hospital procedures and doctors, high advertising costs, and the poor treatment regime behavior of Americans.

Despite the runway inflation, the insatiable healthcare costs and the gloomy outlook, Serigraph is a company that could neither shift costs to consumers as a contingency measure, but under the instructive advice of a successful program from the “Consumer14 Rampant Health Costs Can Be Controlled Driven Health Care”, the company changed its gloomy financial outlook to a successful healthcare program. Among the driving components to success included empowering employees based on consumer driven incentives.

The plan, launched in 2004 January, was implemented upfront by paying $ 2,300 per family and $ 2 million per company. The success of the program depended on offsetting the costs incurred upfront based on a change in the behavior of individuals, higher co-insurances, and deductibles to improve utilization, consumer lifestyle, and purchasing patterns of the consumers. Other components that contributed to the success of the program included holistically keeping people’s health out of the hospital, and using incentives and disincentives to ensure concurrent management of healthcare costs and cost management issues.

The gains based on a successful program started to be evident when people started to appreciate the pace of reforms integrated into the healthcare system based on the price and quality of services offered by the doctors in response to the value of the money paid by the people. Further evidence of a successful program was when a significant drop in the upfront cost incentives patients paid was realized by more than 15%, a strategy which has worked evidently well for six years. Under the program, Serigraph realized a 2.8% increase compared with existing national trends by 2009, an additional evidence of the success of the program.

Based on the results and the continued improvement of the performance of medical services, Serigraph established a cost effective quality program, with the hope that other companies will factor the case for Serigraph as a case study to learn from. It is important to note that the expenditure incurred by Serigraph compared with the national average for the provision of healthcare services for each employer is one third less, leading to cost savings of about 1.5 million dollars a year.

An analysis of the costs shows that it could save the Americans 800 billion dollars with major implications on the costs incurred by the American population. In addition, there is need for strong leadership to drive the growth of companies and reduce the hyperinflation due to large expenditures on healthcare programs.

Get Employees hands in the game

To ensure a successful delivery of healthcare services based on the case study of shifting businesses as is evident with Serigraph which had converted into the consumer driven health plan for cost effectiveness, a number of recommendations were proposed. The winning formula must involve the participation of individual consumers of the healthcare services and their behavior changes, an aggressive and articulate management, a strategy to help people find value in the provision of healthcare services based on market place dynamics, and ensuring people are most of the time kept out of the hospitals.

A typical example is based on the winning formula based on Robin’s behavioral change as a case study. In the case study, the change in behavior as one of the components of a successful program was inculcated in Robin’s character using the concept of behavior change. Evidence in the change of behavior was in Robin’s intelligence and co-worker in the acquisition of healthcare services. The case in the changes of behavior crystalizes from the reference Robin coins about the company by referring it to the “customer” where the people are self-insured and pay more on medical bills.

Another element evident of a successful program is the price insensitiveness of the consumers of the healthcare services, making the demand for quality override the cost sensitiveness of the services provided in addition to the level transparency introduced into the system.

The whole system reflects an inclusive total of the costs incurred by a person in addition to the transparency on comparative quality. One other element that showed the level of success of the new approach is the one successful case that provided the basis for successful cases and company transformation. The basis for a successful program is a genuine demand for better quality health services by a broad spectrum of customers beginning from the grass root level. Based on the demand for quality services by the customers, it is possible that many of the companies could be able to compete in the provision of services for better quality services, which is a combination of quality and services at lower prices.

However, emerging challenges that have become evident in the provision of healthcare services by many companies include adverts that hide the value of the healthcare services, large investments in expensive machines, the use of billboards to advertise their services, and the resulting stressing effects on the quality and cost of services. A successful implementation of the healthcare service provision is based on the ability of the big healthcare service providers which consolidate their selling powers by buying other providers to be the remaining monopolies and consolidate power therefore reducing effects of competition from other interested companies.

Therefore the rate of survival of the small players remains at risk of being crushed in the face of companies. One of the sources of inspiration to inspire change in attitude is based on a nitty-gritty case of Robin’s change in behavior.

Exhibit 22

According to the case in question, the costs incurred for the co-insurance were 20% with a standard deductible of 300$ that became so low the employees did not find it worth getting engaged in. The cost that Robin could have incurred based on the old program was $ 8900 with the company meeting the rest of the $ 6880. However, a successful change in behavior led Robin to voluntarily get enrolled into the program making the company lower Robin’s premium leading to a cost saving of $ 2000. On the other hand, Serigraph saved $ 5400 making the company and Robin save money despite the market place dynamism.

Based on the outcomes of the above case study, it is worth noting that an effective and successful program operates on market driven reforms and behavioral change. The key issues include being proactive and responsible instead of being passive for anyone in the system. The lessons from the above case show that the strength of a successful program depends on behavioral change and not simply on the failed strategies of controlling costs and offering discounts.

All about behavioral change

A successful program entails behavioral change that alters the way people utilize medical services, their purchasing behavior of healthcare services, changes in personal health living styles, the methods of following regimens, and the relationship developed toward doctors. To harness a behavior change as evident from the successful case by Robin against the national debates that have consistently failed to use the best cost saving methods instead of investing in proposals that do eventually lead to cost savings is evident in the benefits accruing from behavioral change as evident at Serigraph.

The driving force toward successful implementation of the program includes employees coming ahead and getting involved in the reduction of annual premium increases, lower co-insurance costs, effective usage and roll forward of personal health accounts to the following years, and staying health and out of hospitals. In addition, the provision of cash awards by taking advantage of free medical services, taking advantage of wellness programs, free primary healthcare services, and free provision of generic drugs. The above elements based on behavioral change contribute positively to the effective employee contribution to the successful implementation of the health program.

A number of suggestions put forward for a successful implementation of behavioral change program that provides the basis for a successful program include motivating employees to change their behavior through incentives, employee empowerment to control costs, and implementing a consumer driven predictable plan to drive growth. In addition, the use of discounts should be discouraged and not taken as a strategic solution to burgeoning budgets and to tame high inflation, but getting employee involvement and making employees gain savings in different ways provides the basis for a successful program.

Utilization Drops Sharply With Individual

The underlying element of a successful program is behavioral change based on employee involvement. Undesirable situations of incurring expensive bills and other expenses forms the basis for the argument for the need to have the people behave responsibly. One of the benefits associated with the people behaving responsibly toward their health care programs is evident in the drop in the number of inpatient admissions, the number of visits made to physicians, and the outpatient visits.

The underlying rationale is to drop the utilization level based on Serigraph’s consumer driven behavioral change program. The typical elements of a successful consumer driven program are a change in consumer behavior as a personal responsibility, consumer based decision making capabilities as opposed to the top down approach of decision making. In addition, Serigraph has only raised premiums for only three times within the incentive and disincentive period they were introduced.

Some of the criticism experienced on the consumer driven approach from elsewhere include the high deductible plans which cause overutilization. That however, according to Serigraph’s consumer driven approach, it is evident that overutilization has completely disappeared.

A number of examples of the success of the consumerism method include the consumer based approach that reduced the utilization and costs drastically since the introduction of the new plan. The drop was below $ 2000 after the plan was introduced. One of the striking benefits associated with the plan is the increase being experienced in the rise of the number of personal health accounts.

Piercing the Fog of Medical Pricing and Promoting Transparency

One component that Serigraph considers crucial for the success of the program is to ensure the insurance premiums are not overpaid for. Serigraph ensures competitive pricing and transparency in the pricing mechanism of high volume procedures. Serigraph shows its prices using a pricing chart to enable subscribers compare the prices with other providers. A typical example is the provision of a colonoscopy done elsewhere because of the competitive pricing and excellent service provision on cancer screening and colonoscopy Serigraph’s employees who works in the maintenance department.

The pricing mechanism that placed the company at a competitive edge with similar providers was the brainchild idea developed by the smart Linda Buntrock with MBA qualifications. Linda developed a pricing matrix that was formed on the basis of keeping the pricing of the twenty three elective procedures that had been negotiated between the parties open to the customers. The argument was that the consumers have the absolute right to know the price of the services they pay for and especially costly procedures. The rationale is to provide services that are transparent, a crucial element in creating a strong will in the market based on a very successful transparency model.

A number of institutions have tried the model in pursuit of implementing a successful program to a broad range of consumers s is evident with Serigraph’s model which uses the anthem data to display pricing on its intranet in the most user friendly manner. In addition to the use of a user friendly display of its pricing mechanism, Serigraph integrates additional virtues to its site which include an inclusion of the doctor’s fees into the hospital and clinic costs, an inclusion of anesthesiology, a complete display of the prices to be incurred by the patient, inclusion of information on quality services referred to as centers of excellence, and the provision of information on 75 type of procedures.

Co-Workers often Seek Help

A typical example on the use of Serigraph’s site is the welcome approach different workers within the company use to seek for help from the human resource department based on the transparency pricing model of the medical services. One component associated with the pricing of the medical services is the discounts offered to customers who enjoy the consumer driven program. The transparency model provides information to the consumers and service providers which enable them to avoid the absurdity associated with the huge variations in price from one hospital to the other. Typical examples are the reforms including the transparency bill proposed by Serigraph in different jurisdictions.

Overbilling is systematic

Transparency is one of the components that underlie a successful program. The underlying rationale is to ensure systematic inclusion of complex bills for procedures is avoided. That is in addition to a number of other smaller errors discovered which eventually place some financial burden on the consumers.

To address the overbilling problem, Serigraph provides transparency to her employees on the costs of the medical procedures, informing workers and other parties to use transparent sites, guide users to centers of value, encourage a positive political view on transparency, encourage the use of the bundle pricing mechanism, reward employees who discover and report billing errors, and push for the enactment of consumer protection laws.

Motivate Employees to Seek Centers of Value

One of the components of a successful program is motivation. The basis for the argument is the wild variations in the pricing of similar procedures across the United States. The lack of Government legislation and market place forces to drive competition and to enable the market dynamics control the prices has compelled Serigraph to adopt a market place model which entails the use of motivation as a tool to win workers and inspire them to seek for bargains. Any flaw in the system specifically on expensive procedures calls for the intervention by Serigraph to cover the rest 100% of the excess charges. The removal of high costs especially for major procedures based on the provision of incentives and appropriate information was one of the core elements that Serigraph used to ensure the success of its program.

Typical of the success of the program was a cash rebate for good buyers. To be successful, Serigraph, as opposed to the carrot approach used by other companies, put in place a system of cash rewards to benefit the people who were seeking medical services from firms which provide excellent services that are of good quality and offered at low in prices in addition to steering the company’s workers to such service providers.

According to Serigraph, the company of choice with the core values of quality and low cost was MedSave. MedSave is dedicated to selective procedures and has provided the quality services for five years with a resounding level of success. A typical cost saving outcome includes cost savings of up to $ 2000.

Quality and core values constitute the components of a successful program as supported by the legitimate rationale of accessing long time doctors and the quality services. Quality as per the program is not connected with the cost of the procedures, but the volume of the procedures. If for example the frequency of doing the procedures is high, the medic performing the procedures acquires more skills in the performance of a procedure, which ultimately leads to better quality procedures. It is important to note here that pricing is not a key component of quality, but is a tool that discourages the provision of quality services.

The key elements to avoid in the pricing mechanism to ensure a successful program based on quality exemplified by Serigraph includes avoiding the hiring of a large number of consultants to minimize the wage bill which is usually transferred to the patient. Serigraph is careful to avoid such scenarios that result in price inconsistencies and irregularities.

Another component of a successful program is clarity and discipline which Serigraph has integrated into the system by providing an all in one bill. Typical cases that informed the cost effective approach was the high costs incurred when one could undergo a minor operation. As opposed to the ineffective approach, the price bundling approach was to include several items into a single price bundle for a number of different types of cancers. The critical issue in this case is to have a single bundle of prices that covers a number of procedures and sub-procedures. Typical examples of companies that have been successful in the implementation of bundled pricing include the BridgeHealth for coronary operations to avoid out of pocket costs, travel costs, joint replacement costs, and a host of other procedures.

In addition to inculcating the concept of transparency in pricing and use of a bundle of pricing mechanism, Serigraph offers free and transparent services including free surgery. The additional component of steering workers to centers of excellence and value provides Serigraph with the foundation of creating a marketplace by ensuring the customers always remain loyal. Another component that contributes to a successful program is the use of a collaborative relationship with the doctor and the patient. In each of the cases, Serigraph requires that doctors refer patients to centers of value and excellence or according to the choice of the patient and not the absolute decision of the doctor.

The Missing Link: Top Management as Change Agents

A successful program must be driven into success by the involvement of the top level management. Toward the successful execution and implementation of a successful program by top level management involvement, the need for business process reengineering based on an aggressive involvement of the top management is crucial. In the context of the successful program enjoyed by Serigraph, the key elements to avoid factoring into the program are to rely on the human resource management to provide direction on the best methods of pricing and creating the cost matrix. In addition, the approach of attacking health costs through the use of health management approach for personal health provides the basis for failure.

Serigraph provides the best example of a successful program based on top level management involvements who act as change agents. The basis for a successful program at Serigraph is to lead by example and getting deeply involved in the promotion of health to bring down health costs.

Serigraph is a company with innovative ideas on how to be efficient and effective in its core business activities. Typical of the success factors is the behavior of the management which consists of aggressive managers, as one of the components that drives the program to higher levels of efficiency and value. The approach of benchmarking aggressively enables the management to seek out the best business practices based on the learning dynamism of the organization.

Another element that Serigraph has integrated into the system is a wellness program by directing the people into the centers of excellence by directing the customers to points that offer the best value for the customers based on the quality of procedures provided. Serigraph has in place a program for the provision of services based on best practices.

Health metrics tracked

Evaluating the metrics used as the basis of benchmarking a system is one approach Serigraph uses in its successful program. Serigraph has in place a system for tracking health metrics to ensure quality and effectiveness. One unique element that enables successful execution of its programs is the fact that the company ensures that the information obtained by tracking its health metrics is used to form the basis for action points in determining the course of action to take to ensure success.

That is in opposition to other companies which do not take and analyze the data obtained from the tracking of the health metrics and take action on the results from the data. The rationale for tracking healthcare metrics is to ensure costs are lowered based on the proactive nature of the management and not the other way round of relying on theories that are never put into action.

Change Management

Serigraph is an action oriented company. The organization knows well that change management is one of the factors that lead to success if the process is appropriately put into action. At Serigraph CEOs take the responsibility of ensuring that change that is based on total quality management in the provision of healthcare services is characterized by spectacular innovation. To achieve and effectively implement the system, Serigraph is always careful to eliminate any errors in the system using a better business model, aggressive management methods, and aligning the incentives provided based on the prevailing economic performance.

The key words include discipline, management aggressiveness, elimination of errors, and total quality management to ensure the system is not susceptible to inflation. It is therefore important for any organization; in context of the approach Serigraph uses, to ensure complete executive involvement in the program as proactive change agents, applying change management best practices, and providing rewards for healthful behavior.

Beer, Brats, Butterfat: Health, Lifestyle Can Be Managed

In pursuit of a unearthing the underlying principles that drive S Serigraph to implementing a successful program, the components that define the success include providing patients with the appropriate information based on Serigraph’s proactive model. In the model, the crucial element is collaboration with the service providers and the patient as proposed elsewhere. The collaborative model is regarded as a crucial component for successful implementation of the program because of the wellness education element and to be proactive in the management of the personal of the customers.

The challenges to overcome in this case are to provide the customer with appropriate information on the best method to preserve their health and reduce costs. In addition to that, the success of the program is based on early intervention on providing medical care appropriate for any problem discovered early.

According to the proactive approach Serigraph has invested in, there is the need to be involved and to sign up to an annual physical for employees and other co-workers. The approach has been used successfully by the company because it entails early intervention and education in costs that could have been incurred should the patient undertaken a late medical treatment instead of early intervention and treatment.

In accordance with the success of the program, it is established in the literature that taking the mini physical is not expensive. In addition to that, Serigraph takes responsibility of providing services using the company’s nurse practitioner to offer the services for free to employees and co-workers and others in need of the services. The underlying need to protect the privacy of individual information of the people who undergo the physical process is protected by the privacy laws of the United Sates.

A drastic reduction in the number of people in demand of the procedures that include cancer treatment and procedures has been drastically reduced because Serigraph has embarked on the project of initiating by integrating health management program. Typical case studies that yielded data on the success of the system included the proactive diabetes management program that is executed based on the concept of being perfect.

The critical elements include identifying the problem, determining the number of regimens, and using or employing the professional to provide appropriate guidance in contacting the best people to provide guidance for the diabetic people in managing their health to acceptable standards. In addition, each diabetic is given a reward when tests done on them fall under the standard measurements. It is important to note that the Serigraph integrates the concept of total quality management by ensuring that any weaknesses in the system is always addressed and the root cause identified and solutions to the problem identified in time.

One of the core elements identified that contributes to the success of the program is behavior change as discussed elsewhere in this paper. In addition to ensuring the principles that govern the operations in any quality system are in place, Serigraph has embraced the concept of lean enterprises that active participation of all employees in seeking for solutions to any problem.

In context therefore, the components that define the successful system include a wellness reward system based on a complex point system, wellness days that are paid for, charging smokers a higher premium of 10% above normal rates, providing coaching for workers with health problems, and the provision of free primary healthcare services by a doctor with the aim of bringing about health management into the lives of the patients, prevention, wellness, and the provision of programs that have been formalized for the management of chronic diseases.

Other critical points include investing and integrating a wellness program into the lives of people and employees, providing onsite fitness services, encouraging the people to invest in a wellness program, establishing a culture where people walk around the campuses, and providing sponsorship programs that involve people in walking and running events. Typically, the entire system relies on the approach of providing incentives to people to stay healthy.

Primacy of Primary Care Delivers Big Savings

The principle components of a successful program include proactive involvement of the management in providing appropriate healthcare services to the people. Many case studies exist that have informed Serigraph in the best method and model to use to provide healthcare services to the people. One of the instructive models the organization considers appropriate is the quad model. The core elements of the model are to deliver quality healthcare service to the people at affordable prices leading to patient satisfaction, cost control, and improved healthcare provision.

The success in the application of the quad model is to supply doctors on site. Serigraph has based its model on the results from case studies that have proved successful based on the concept of providing doctors on site. To provide doctors on site despite the lack of the critical mass required to fulfill the demand raised by the people who require medical attention physically, Serigraph innovatively addressed the problem in a clever way. The company provided online services under the leadership of a chiropractor, dietician, nurse coach, and a practitioner nurse. The successful integration of the services in an online platform with the specialists showed a significant reduction in costs, a drastic increase in the ability to execute disease management program, proactive movement toward value, and provision of intimacy of care to the people.

The quad model adopted by the company provided additional benefits which included a bottom up approach to the provision of healthcare services and proactive reform and not about elements of the program that do not work. The essence of the program is about what works based on the building blocks of the model. The building blocks include a critical consideration of the methods used to compensate doctors by paying them base salaries while ensuring that they provide quality services by giving them small incentives as opposed to the system that compensates doctors based on the procedures they perform.

The strength of the system is that the doctors get motivated and experience job satisfaction to attend medical schools out of the work and the system they work for. Another component that is a driving force of a successful program is the use of electronic records to store information about the patients and enable the doctors and other medics provide better healthcare to the people. One element that characterizes the electronic system is its ability to provide up to date information about the any procedure or operation that is due, requiring immediate attention of the doctor

The Quad approach that has been integrated into the system adopted by Serigraph is the prevention concept. Under the concept, the people are taught on the need to reduce medical costs by practicing preventive measures instead of waiting for a full blown situation that requires expensive medical attention. The quad model outlines a framework which basis use doctors based on electronic records that generate regular reports about the patients to provide timely Medicare and intervention to prevent the health of any patient on the system deteriorating to the extent of demanding specialized procedures.

Another component integrated into Serigraph’s organization system based on the Quad model is the inexpensive office visits. The strategy here is to charge workers little money as possible for each visit they pay to the office and ensuring that the employees spend as little time in the hospital as possible. A typical situation shows that the time spent at the hospital is 21% of the national average.

The core element of the quad model is a medical home that is characterized by a number of coordinated activities which are run by nurses and doctors who work on electronic records stored in confidential files. The entire system is coordinated seamlessly by the medical service providers who rely on electronic records consisting of prescriptions, images, and all categories of information to assist the doctors and nurses provide appropriate medical services and treatment. The number of medical service providers depends on the basis of the need by the people to avoid expensive staffing and costly investments.

The next element in the system underlying a successful program is a wellness program to ensure the people keep fit. To reduce the cost of Medicare provisions, physical therapy is made easily available and accessible in addition to a program that helps employees in providing advice on personal problems such as budgetary problems, addictions, and depression problems. Despite the success some of the organizations such as QuadMed have gained without converting to a consumer driven plan, the successful integration of the concepts of the quad model into Serigraph’s consumer driven plan has revolutionized the way Serigraph has successfully enjoyed and implemented its consumer driven plan.

The beauty of it all is that the organization uses innovative best practices enjoyed using the market place dynamics. At Serigraph, success is driven by employees such as nurses who provide direction to patients on the best service providers often referred to as centers of value. That is in addition to the provision of professional services including mini physicals and blood draws.

As mentioned elsewhere, the need to provide professional services drives Serigraph into providing services by encouraging medical professional to provide coaching for people suffering from different ailments such as high blood pressure among other medical conditions. Among the components that have driven Serigraph to success include the introduction of different medical professionals into the program to provide healthcare services from a professional perspective.

In addition to that, the introduction of the prevention program provides the system with large cost savings because the patient is spared the cost of being provided actual medical services. In addition, it is crucial to note that the issue of trust coupled with the onsite medical delivery without disclosing confidential information about the patient.

The underlying principles that make the program successful include the onsite provision of medical services using specialized personnel. In addition, the critical point that drives success is the issue of convenience at workplaces low out of pocket expenses, and at time free services provide the basis for a successful program. Another component that Serigraph integrated into its system is based on the ModernMed franchise model. Based on the model, the organization can pay a flat rate for the family while providing payments for contracted physicians at flat rates irrespective of the number of patients. On the other hand, the model requires that Serigraph provides services by using professional medical service providers.

The core to a successful program is the provision of services to those in need by motivating doctors and other medical practitioners to guide patients to the centers of value in addition to the willingness and providing dedicated doctors who provide dedicated primary care services. That is in addition to the benefits Serigraph’s co-workers enjoy in the provision of chiropractor for physical therapy.

The critical components that drive success include establishing a strong relationship between the doctor and the patient, and the player and the provider. In addition, the provision of value based primary Medicare services, which is the primary component to success because effective primary healthcare services lead to significant cost savings. The key words are intense primary healthcare services, a medical home, and avoidance of nonsensical Medicare pricing policies.

A summary of the learning points that Serigraph provides as a basis for a successful program includes improving healthcare through free or low priced clinical services, dedicated provision of free primary healthcare services, establishment and seamless integration of medical homes, and use of the on-site medical services to reduce healthcare costs significantly. In addition, payers of the primary healthcare services should be given the responsibility to control the provision of healthcare services which eventually reduces the cost of such services without placing unnecessary medical costs of the payers of the services.

It is important to consider the issue of on-site medical services as one of the primary components of a successful program as a cost reduction strategy and a proactive medical prevention approach. The overall impact is to reduce costs and the number of visits to hospitals for specialized procedures. In addition, it is important to involve payers because they have the responsibility of contracting flexibly depending on the primary care needs by workers.

Quality Ratings Elusive, But Essential

Studying the underlying components that have driven Serigraph to success, it crystalizes that quality is a critical element in the success of the program. Quality is the basis for the success in reducing the number of mortality rates to 40%, reducing the cases of pneumonia, the low percentage of heart patients admitted and readmitted to the hospitals, and a decline to zero the number of sterna infections. The underlying strength is the reduction in the cost of healthcare services and the provision of quality services.

The critical elements of a successful program that Serigraph has integrated into its systems include quality audits, which can be found in any system. Serigraph undertakes to identify any weaknesses and non-conformance in the system for healthcare providers. It is important to conduct repeated audits to identify deviations from any conformance standards and to perfect the system by taking corrective actions to perfect the system the rationale is to ensure conformance to quality audits.

Serigraph is always proactive in using different procedures to judge quality. The number of procedures performed in a given period and the quality of the procedures are evaluated against the quality standards to ensure conformance of quality. It is well known that quality is one component that that can be used to attract more patients, therefore, increasing the volume of procedures done in a given period.

In addition to the provision of quality services, Serigraph encourages doctors to search through volumes of information contained in the database designed for Medicare purposes. The wealth of information available from the databases provides information which is used as an indicator of the number of high value providers integrated into the network of high value providers which Serigraph considers a valuable component.

One of the arguments put across as the basis for quality is for the federal government to mandate quality and disclosure. Serigraph embraces the concept of quality disclosure to provide patients with appropriate information about the best doctors to visit for the procedures they want to undergo. Serigraph provides an interactive environment between the patient and the nurse who seek for information on the best doctors to visit and the centers of excellence they should attend. The critical component that Serigraph proposes to politicians is to be advocates of quality.

The essence of providing quality is transparency. Transparency entails providing consumers who foot a very large bill quality data that enables them identify the centers of value where they can get the best of the services they need including procedures they want performed on them. In summary, it is critical for the customer to adhere to the guidelines provided by Serigraph for one to search through a large volume of information that provides the basis for hiring a health facility or a doctor. In addition, there is need, as is evident with the Serigraph system, which patients are provided with quality statistics in addition to embracing transparency, besides encouraging political goodwill in encouraging such institutions to be transparent.

To Reform: Educate, Communicate, Hyper-Communicate

A study of the underlying components that act as drivers to the successful implementation of the healthcare program at Serigraph is pro-activeness in providing workers with the right information about their health conditions. In addition, at Serigraph, information is made available by a proactive involvement of the health coaches through a face to face interaction with coworkers and third party workers. In addition, the communication forms the core component Serigraph emphasizes on, to provide patients and co-workers with information on the sensitive information of its financial performance and statements. The basis for delivering information to the appropriate audience is by using the right communication device to reach the customers.

One of the most relied on communication device is the website that belongs to the company. The website contains the latest information about any developments in medicine and any new outbreaks or discoveries made.

At Serigraph, the management is aware that to plan changes is not an easy task to execute. Intense commitment to the health of the stakeholders and the provision of the right information to the patients and the workers has worked well at Serigraph. The provision of information formed the basis for the incentives that enables people to switch to the higher deductibles. The rationale for such success in intense education on healthcare economics which are introduced and implemented based on the theories of change management.

Change management provides the company with the framework to introduce change based on an outline of the crisis in the sector and the threats hyperinflation had on the competitiveness of the company. At Serigraph, it was realized that sending repetitive messages with the aim to communicate information to foster understanding was a critical component to the success of the system. Serigraph emphasizes on repetitive communication as one of the components of a successful program when integrated into the system. In addition, communication and understanding form the most critical component in informing the workers and other stakeholders about the good deals offered in healthcare and the best doctors to attend the patient.

In pursuit of understanding the principles of a successful program as exemplified at Serigraph, results show that the target website should contain such good stuff that is transparent on the medical services they provide, cost, and the quality of the procedures on offer. In addition, the doctors and the centers of value should be identified on the web to enable patients get the quality information they want on a service they are looking for.

Information hosted on the sites should also clearly organized and presented to enable the prospective patient identify the best procedures available for a given condition. The organization and display on the website of information provides patients with improved decision making at Serigraph. The company relies on nurses and corrects channeling of information to the appropriate websites that host information about the sites having information about the best doctors and centers of value who offer the best procedures that have been proven to be effective based on statistical data.

Serigraph provides patients and doctors with the right to share information on decision making enabling the company to avoid problems associated with poor decision making outcomes. Serigraph enables co-workers to access information on second opinions about selective procedures by providing the services using doctors who offer their services online.

In addition to that, the company provides information on end of life decisions as one of the components underlying the success of the program. The underlying rationale that Serigraph has identified as being critical in the end of life decisions is the cost implications of any decisions made. The key elements in this case that drive success at Serigraph is enabling workers and other stakeholders to make informed decisions. At Serigraph, the appropriate education and communication are key component drivers of the success of the program.

Serigraph has also invested in a personal health and communication education plan which acts as a tool to ensure a patient’s data is integrated into a single file for the purpose of easy retrieval.

Silver Bullet for Better Value: Lean Disciplines That Transform

Serigraph ensures the lean manufacturing concept underlies its operations to ensure a successful program. Typically, Serigraph has made the Medicare program a success because human resource management makes based regular attendance meetings with cross disciplinary teams to get informed on methods to perfect performance in Medicare services.

The basis of the success of the program is lean management, quality, introduction, integration, and acceptance of necessary change, and to dynamically use emerging business models that enable the systems to be of economic quality. At Serigraph, the economic quality model enables the company to collaborate with other institutions on a range of issues including integrating into its system quality measurements that keep the company ahead of its competitors. One of the elements that the organization finds vital in the provision of quality is the use of the voice of the customer.

The voice of the customer provides the Serigraph with the opportunity to interact with the opinions of the customer by accepting input from them that enables the company to make continuous improvements. The key elements that Serigraph considers of value in implementing continuous quality improvements as one of the components that underlie a successful program include value, prices, and service. The most important idea Serigraph considered as being a key component to the success of its program was quality that was provided at the Centers of Value identified by the company.

The underlying theory upon which Serigraph bases its quality concept is the lean theory. Based on the theory, Serigraph has integrated an environment that enables the customer’s input to be the foundation upon which decisions are made starting from the time the patient reports at an institution until the time when the patient leaves the health institution.

In context, the success of the program at Serigraph is based on the premise of identifying lean providers of health and recommending people or patients to pay their visits in such institutions. In addition, Serigraph has successfully driven its program based on the key components of quality, services, and price. A study of the system shows change to be critical and it should be introduced in a stepwise procedure. The basis of a successful program is the value of the services and not the price.

Generics, Loss Leaders Provide Leverage on Drug Costs

Serigraph takes the market place concept as being the critical component of a successful program based on creating a marketplace with the ultimate aim to reduce Medicare prices. The underlying success is to make the healthcare an affordable affair making the company and co-workers save money. The success of the program is to use some of the best purchasing techniques to provide affordable healthcare services based on ensuring co-workers get involved in the as the agents who bring change. Towards achieving success, Serigraph has imposed some restrictions by providing medical cover on certain drugs. In the provision of cost effective services, Serigraph provides services that has its basis on using pragmatic managerial techniques.

One of the successful methods used by the company is to use a proven management technique of bidding out the drugs of a company that have been under patented. The bidding enables the company get the best discounts either in public or private sectors.

Because of the problems associated with the process of competitive bidding in the provision of less costly Medicare, the best proven management technique is based on the provision of incentives and disincentives to the stakeholders. It is a three tier technique that is involved in the process.

The three tier system involves the use of low co-payments, where generic drugs are bought by the customers. In the tire, expensive drugs are exempted from the list of recommended drugs. The basis for the success of the program is to ensure that low cost drugs are used, and to ensure that any opportunity that arises in the context of the market place dynamics. In addition, recommendations have it that the use of the tree tier architecture should be basis upon which drugs should be purchased, and that organizations hoping to be successful in the implementation of their programs should bid out drugs.

Better Model for Desperate Small Companies

Success at Serigraph to contain hyperinflation provides a leaning point for other institutions and insured smaller employees. One components of a successful program is spreading risk to avoid the health nightmare of smaller companies face in buying insurance premiums. Instead of the approach the smaller players use to provide insurance cover of the employees which lead to expensive payouts, the model recommended for the smaller players is the ultimate care. Under the model, a retainer-based primary physician provides coverage at the base of the whole spectrum while the higher spectrum care is charged premiums such as $ 7000 per family. In this case, the events that lead to cost catastrophes are avoided.

The uncovered gap that exists in the middle region is covered by a health account to ensure effective cost sharing depending on the employee’s choice. The results show a sharp decrease in costs to offset the price of the primary care giver. In addition, a reduction in the health costs occurs because of the successful implementation of the program making the business experience a reduction in the fundamental costs.

Other components that make the program successful include the benefits employees get in the form of stable premiums and the intimate primary care accruing with the retainer playing a significant role in overseeing the medication of the patient. The underlying elements of a successful program include work behavior and consumer engagement. In addition, the retained doctors play a significant role in providing customers with direction to the centers of value where services statistically proven to be of good quality. The success of the model provides an excellent basis for taming hyperinflation especially for businesses that cannot be able absorb the shock of the turbulences associated with the high costs of providing medical services.

In summary, the components that define a successful program that Serigraph has integrated into its system include the cost and health management component that is based on a consumer driven plan which factors employee involvement. There is also the component that defines a successful program based on the use of qualified companies to use government tax credits, and the need to educate people to participate in keeping them out of expensive hospitals by educating the patients to change behavior and get proactively involved in primary healthcare management. In addition, there is the component of the mini physicals that Serigraph has integrated into its system purposely designed to catch medical problems earlier for early intervention to reduce treatment costs.

There is the education component that is critical in teaching people the value of seeking for value in the healthcare marketplace based on the pricing and quality of services on offer.

Private Sector Reforms Trump Government Efforts

Despite the advances in medicine that have been experienced in the recent past, even to the extent of making personalized medical services and medical breakthroughs, it is possible that the majority of American citizens will not benefit from the scientific successes in medicine. The underlying problems include high insurance premiums which are caused by high medical costs and prices. The hike in the insurance premiums and other high costs placed more weight on the government besides making companies continue to drop paying for the covers and forcing public sector increases in spending.

With the stark reality, Serigraph has done exactly the opposite of increasing the payments by ensuring the costs remain low with the provision of a full plan. Another approach is to provide low income earners with a health account, co-insurance, and reasonable deductibles. The approach could lead to significant cost savings because needlessly expensive procedures could be accommodated and avoided and applied when need arises. The ripping off of the system finances could be avoided as evident at Serigraph. A unique approach is to ensure the customers make out of pocket payments for those entitled to the program in addition to integrating into the system new reforms and innovations.

The key elements to focus on include changing who pays to bring about changes in consumer behavior and integrating the concept of market place consumerism. In addition, the use of tax breaks, the restructuring of the payment systems to ensure payments are complete and to make bonus payments for good outcomes contribute to the components that define a successful program.

In addition, it is crucial to ensure the success of the program is based on a providing primary healthcare as the foundational pillar, operate on the principles of lean management, employ the use of mini physicals, and ensure that the entire system is transparent besides creating a home for the medical services being provided. The success of the program is based on investing in individual responsibility, investing by focusing on Centers of Value, focusing on primary care for early intervention.

Assessing the Author’s Concepts to the US healthcare system

Having examined the components of a successful program as exemplified by Serigraph, the following is a discussion and comparative analysis of the author’s concepts compared with the current healthcare reform (PPACA).

According to the author, Serigraph is the company that provides solutions to problems which lead to large financial bills that companies, individuals, and the government are footing. The solutions, according to the author are based on borrowing and integrating the concepts and theories of lean manufacturing. On the other hand, the healthcare reform does not integrate the lean concept, but on minimum coverage that is “affordable”.

Consumer involvement in decision making, transparency in the provision of medical services, creating Centers of Value to which patients can be referred to when seeking for the best qualified doctors, educating employees on behavior changes, and getting involved in consumer driven plans. Here, the healthcare reform focuses on auto enrolment based on a minimum number of employees with businesses required to conform to 250 the number of employees subject to the aggregate cost of health insurances. According to the author Serigraph organizations and employees bear individual responsibilities to conform to the plan.

The author emphasizes on transparent in pricing, ensuring that workers get the best out of the healthcare plan, being proactive in change management, using an elaborate point system, using an inexpensive heath risk assessment process and the provision of healthcare at low prices. The author emphasizes on individual responsibilities but the reform plan emphasizes on creating categories of marketplace people for health insurances.

The reform plan emphasizes on compliance to the essential health requirements to include people classified into Section 1302 of the PPACA without any benchmark as opposed to the innovative use of existing market driven benchmark used at Serigraph.

The health reform does not emphasize on market driven dynamics based on consumer demand and preventive services in the context of educating people to seek for preventive Medicare services to reduce costs, but 100% coverage for co-pays for all class A and B ratings. In addition, the reform plan has in place deductible limits, minimum values, insurance rating reforms based on individual, geographic, tobacco, and age ratio. The difference in the reform plan and the writer’s concept is consumer involvement, transparency, quality, Centers of Value, and marketplace dynamics and government driven cost reform.

References

Torinus, J. (2010). The Company That Solved Health Care. Adfo Books.

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