Comstock's magazine 0919 - September 2019 | Page 42

n MERGERS
DISASTER
Cordova Church of Christ in Rancho Cordova experienced a major
sewer backup. The cause was unknown, but throughout the
church’s campus of five buildings, all bathrooms and sinks were
flooded.
RESPONSE
Pinnacle Emergency Management, Northern California’s premier
restoration contractor specializing in disaster-related damage,
repaired administrative offices, kitchen and breakroom areas, a
children’s nursery, and bathrooms. “We replaced drywall; repainted
walls; removed, cleaned and replaced appliances and office
workstations; and with monumental assistance from Master’s
Wholesale flooring, refloored 15,000 square feet,” says Leo Grover,
Pinnacle’s founder. “Cordova Church had been preparing to host
their annual summer camp for 600 children, so we kept to a tight
timeline, finishing the job in only five weeks and enabling them to
accommodate campers as well as a wedding.”
“Everything from Pinnacle’s project manager, Bob Morico, our
adjuster, Jerry Griffin, to our final cleaning was seamless. Go,
Pinnacle!”
— Kin Davalos | Office Administrator
Pinnacle Emergency Management
916.371.7431 | www.GoPinnacleNow.com
Before a crisis or disaster hits, call Pinnacle for a
free evaluation of your company’s needs. CSL#897165
42
comstocksmag.com | September 2019
groups of providers that agree to closely coordinate their
care to avoid unnecessary procedures.
If there’s an uber-ACO out there, it’s Kaiser, made up of a
health insurance plan, physician groups, a hospital system
and now even a medical school. A 2015 report by the Brook-
ings Institution pointed to Kaiser’s integration leading to
better outcomes and lower costs. Kaiser providers all use
the same electronic medical records system, doctors work
in teams with other providers like psychologists and social
workers, and providers operate under the same goal of keep-
ing people healthy and out of the hospital rather than gener-
ating lots of billable services, the report says.
Providers have responded to the federal push for ACOs
and the competitive pressure of Kaiser’s model. Sutter
launched its own HMO in 2013, Sutter Health Plus — an in-
tegrated network of hospitals, doctors and other health care
services. Other systems in the region — like UC San Francis-
co, Stanford Health Care, Canopy Health and now Common-
Spirit Health — are following suit, says Dard Hunter, a senior
vice president at Lockton, a benefits broker and consultancy
that has an office in Sacramento. It’s an acknowledgment, he
says, that “Kaiser has won the battle of the model.”
If integrated systems can deliver on better patient experi-
ence, better health outcomes and lower cost, then everyone
wins, says Hunter. But Chad Follmer, a senior vice president
at the Sacramento office of Woodruff Sawyer, an insurance
brokerage and consulting company, is skeptical about that
last part — lower cost. He points out that sometimes a merger
can save a struggling rural hospital, which benefits everyone
who lives there. But overall, “When like-sized systems come
together in health care, they don’t get rid of anybody,” he
says. “And it’s because that merger isn’t for efficiency. It’s for
negotiating power.”
HOW BUSINESSES CAN TAKE BACK
(SOME) CONTROL
Businesses shouldn’t count on the ongoing legal and legisla-
tive battles to keep their health care costs reasonable — they
need to search out alternatives, say benefits experts.
For large companies with about 500 employees or more, the
most common solution is self-insurance — cutting out health
insurance companies and paying providers directly. Plans like
that covered about 5.7 million California workers at last count.
Under the self-funding approach, experts point to one prom-
ising strategy: reference-based pricing. Instead of accepting a
health care provider’s list prices as the starting point, employ-
ers set the price they pay — say, 175 percent of the Medicare
fee — and then negotiate from that starting point as needed.
For large companies that can’t enroll in an HMO because they
have many employees outside the region, that may be the most
promising option; companies that use it save 5-15 percent on
costs, according to a March 2018 Lockton report.