HEALTHY CHOICES: Insurers, providers and patients navigate an ever-changing health care landscape.

• Position: HEALTH CARE ROUND TABLE

FROM PREVENTIVE MEDICINE TO PALLIATIVE CARE, CHOICES CAN BE DIFFICULT.

Health care in the modern environment takes not only a holistic approach but involvement with every facet of the system. Everyone concerned needs a renewed education as to what it takes to deliver quality health care without breaking the bank. Business North Carolina magazine assembled a round table of experts to address the issues that concern us all.

FROM YOUR PERSPECTIVE, HOW'S BUSINESS? IF BUSINESS IS GREAT, WHAT DOES THAT MEAN?

STANCIL We're consultants for midmarket employers, and for us, business is incredible, double-digit growth for years upon years because health care's gotten so incredibly complicated, as all of you live with every day. You've got [medical costs increasing] somewhere between 6% and 10%, depending on who you talk to. Prescription drug [costs are rising] double that, typically year over year. You've got employers that we serve just hemorrhaging money when it comes to insuring their employees and trying to provide the best plans at the lowest cost, and just looking for answers, trying to find ways that they can use those dollars to serve their employees in the best way and not waste it and make sure the employees have the best health care experience.

ADCOCK Working for an employer that provides on-site health care, business is good for a lot of reasons. Our employees understand the benefit of getting great health care for no cost --we do everything for free. There's no copay, no coinsurance, and our on-site facility saves them time. It's great for SAS, because every time someone uses our health care facility, they do not use the health plan. We don't bill our own health plan. That would be just taking money out of one pocket and putting it in the other, and that's a waste of time and money.

Last year, we saved employees $1.2 million in avoided out-of-pocket copays and coinsurance, based on what they would have paid on the plan. But we also saved SAS $3.5 million in avoided claims cost, over and above what it cost to run the health care center. When we started, SAS had 200 employees (it now has more than 14,000), so this is totally a scalable idea. Just because you can't do everything doesn't mean you shouldn't do something.

LAWLER For the NCHA, business is busy, and the definition of good is like art: It's in the eye of the beholder. It's busy across the field, and it's busy in regard to hospitals and health systems adapting to regulatory changes. Hospitals and health systems are accountable, which is defined today very differently than it was 10 years ago. We have hospitals and health systems that are really focused on the value proposition. We're focused on making North Carolina a destination for the best care and value. It takes time, energy and effort. One of the reasons it's busy for the association is we don't have a homogenous state. We have hospitals and health systems that are extraordinarily advanced. We also have some that are still in small communities that are working on building essential skill sets to succeed and connect with...