BUSINESS KEY TO MEDICAL REFORMS

Although legislation died in Washington last year, health-care reform is "alive and well," the president and chief executive officer of the National Business Coalition on Health said here Wednesday.

Business and industry are responsible for a "conservative revolution" in health care as they demand increased quality and lower costs from providers, said the coalition CEO, Sean Sullivan.

Based in Washington, D.C., the coalition represents employers such as Coors, American Express, Disney and General Mills as well as a number of small businesses in 90 cities.

Employers around the country started the revolution by treating health care as if it were any other commodity they needed for their business, from raw materials to office supplies, he said. They formed coalitions to create health-care purchasing power, issued specifications on what they needed and invited providers to submit proposals.

"Health-care reform in many people's estimation died last year in Congress, but that's only from the viewpoint that it has to happen in Washington," Sullivan said. "We think it's happening, and it's really those of us who are out here in the trenches that are making it happen."

Sullivan was among the speakers at a Southeast Missouri Business Group on Health seminar titled "Moving Ahead with Managed Care."

He said the nation's health-care system is being guided by the same principles guiding many industries: quality improvement and quality management. Employers need to rethink their roles by becoming purchasers of health care rather than merely buyers, with an eye toward getting value for their health-care dollars, he said.

"A lot of employers were out there without the foggiest idea of what they were buying. They need to pay attention to the specifications of what it is they're paying for," Sullivan said.

By forming coalitions and looking at employees as potential customers for health-care providers, employers can create purchasing power and a competitive market for health care, he said. If health-care providers don't become more competitive in terms of price and value, they risk losing those customers as insurance companies and providers opt for managed care, which can be offered at a lower cost, Sullivan said.

Employers' role in health care has "changed from whining to designing" as they take the initiative in creating a marketplace, he said.

An improved health-care-delivery system, with mechanisms in place to assess quality, address needs and provide both a continuum of care for employees and incentives for providers, is "the bottom line" in health-care reform, he said.

"We have to collectively hold the provider accountable for cost and performance."

Any legislative reforms to the Medicare program will bring "profound changes" to health care in general, Sullivan said.

He predicted that health-care delivery will continue to evolve, but "in the long, long run, employer-based health care is going to have to go because I don't think it's sustainable."