The Milwaukee Post

May 11, 2018 • Milwaukee County Post • 9 By JOHN TORINUS To prevent business disasters like the diesel emissions scandal that torpedoed Volkswagen's reputation and resulted in criminal charges against its CEO, corpora- tions like West Bend Mutual Insurance and Rockwell are going public with rigorous ethics campaigns. They are spreading mantras of corporate integrity and individual responsibility inter- nally and externally because they think it's good business to do so. Both companies were recently honored for their best practices in promoting ethical behaviors. West Bend received the Torch Award for Ethics from the Better Business Bureau, and Rockwell was recognized by the Ethisphere Institute as one of the most ethical compa- nies in the world. It was Rockwell's tenth year on the list of 135 global honorees. West Bend CEO Kevin Steiner said his company works to make high standards part of employees' daily routine. Rockwell CEO Blake Moret said, "Integrity and honesty are part of our corporate DNA." Many companies have codes of ethics and are quiet about them. Given all the slams on corporations by legions of critics, it's good to see CEOs like Steiner and Moret make the case publicly for upright corporate behavior. The world needs to know that a very large majority of companies work hard to walk the walk when it comes to doing business the right way. Speaking recently to the Unversity of Wisconsin– Milwaukee's Lubar School of Business Advisory Council, Moret said he uses all means of communications possible to reach Rockwell's 20,000 people. As he trav- els to Rockwell's worldwide locations, he often spreads the ethics message to groups of 20-30 people so it can ripple across the organ- ization. "CEOs are being asked by their boards to be symbols of integrity," he said. The challenge facing CEOs, he said, is that companies are "only as good as their weakest links." In other words, the company's ethical standards need to be accepted and embraced by every employee. Think about the damage done to the Wells Fargo brand when a broad range of its employees signed up customers for fraudu- lent checking, savings and insurance accounts without their consents. The pressure from the top to cross-sell affected 3.5 million accounts and resulted in major fines, horrible press coverage and the departure of 5,300 employees, includ- ing CEO John Stumpf. Wells Fargo had been a stable operation and weathered the Great Recession better than most banks, but clearly its ethical founda- tions were unstable. Three whistleblowers finally put an end to the fraudulent practices. Moret outlined a range of best practices that keep Rockwell on the straight and nar- row: ■ Board and executive commitment to high ethical standards. ■ An integrity champion award to an employee each year, given last year to a work- er in Chile who put a stop to a smelly deal before it got done. ■ A single code of conduct for all parts of the world, regardless of local customs and practices that don't measure up. ■ A Business Standards Compliance Committee to set the rules. ■ An ombudsman who investigates every complaint or ethical issue raised and makes sure that no retaliation is taken against whistleblowers. ■ An internal audit committee, standard for most public companies. After his remarks, Moret agree that ethics are about more than the absence of negative behaviors. Ethics are about morality, what's right and what's wrong. An ethical company also does many things right by delivering reliable products and serv- ices, by treating its stakeholders right, and by civic and charitable actions at the corporate and individual employee levels. "It's a constant journey," Moret said. "Employees have to understand that it's up to each of them." (John Torinus is chairman of the board of Serigraph Inc. in West Bend and blogs regu- larly at www.johntorinus.com. His column runs occasionally in the Post.) OPINION By REP. JOE SANFELIPPO Americans across the country have dis- covered that the Affordable Care Act has been anything but affordable. Many Americans and businesses are struggling financially to pay for health care. At the same time, the primary care experi- ence has declined in quality for both patients and providers. Patients have seen their access to primary care decline, for many reasons. With the trend toward spe- cialization among medical professionals, the percentage of primary care physicians has dropped significantly in recent years. This is also part of the reason that average wait times for initial visits to family physi- cians in major cities have increased from 20.3 days in 2009 to 29.3 days in 2017. In mid- size cities, that wait climbs to over 54 days. As more people are forced into high- deductible health plans, many patients can't afford to pay for visits or take the time off of work to get to their doctors, even when they can schedule an appointment. Doctors don't like this trend, either. In typical insurance-paid practices, doctors spend roughly 50 percent of their time deal- ing with procedure coding and insurance requirements, and need expensive adminis- trative staffs to help manage complex billing and records systems. The result is that doctors need to see more patients to achieve profitability, which means less time with each patient. Many doctors, frustrated with this experi- ence, have begun shifting to a new business model known as direct primary care, or DPC. Under a direct primary care model, which is not health insurance, patients pay a low monthly fee, typically between $50 and $100, depending on age, with no further co- pays or deductibles. For that fee, they receive unlimited 24/7 access to their pri- mary care doctor. Because doctors have a fraction of the administrative costs as under a managed-care model, they can spend more time with patients: whereas under a managed-care model, doctors see their patients for an average of eight min- utes, DPC visits average 35 minutes in length, and often go much longer. This extra time allows doctors to get to know their patients better and provide more accurate diagnoses. And because DPC doctors typi- cally accept roughly 500 active patients com- pared with 2,500 in traditional practices, doctors are available to their patients 24/7, whether for same- or next-day appoint- ments, phone calls, or even house visits. Switching to a DPC model can save doctors as much as 40 percent on their administra- tive costs by freeing them of insurance billing requirements. Under direct primary care, patients receive better health care for less money. While over 80 percent of a person's health care can be provided in a primary care set- ting, DPC patients still carry catastrophic insurance for coverage should they experi- ence a serious illness. However, because they receive more regular and in-depth pre- ventive care, patients under a DPC model experience better health care outcomes. This translates to massive cost savings. Hospital costs for potentially preventable conditions (those that statistically respond well to increased primary care) represent roughly $30 billion annually, or 10 percent of all hospital expenditures. DPC patients are 52 percent less likely to require hospitaliza- tion than patients under a traditional model. If we can even marginally reduce the 4.4 million annual potentially preventa- ble hospital stays, we can make a revolu- tionary impact on our health care problem. That's why Sen. Chris Kapenga and I have been working on legislation to formally cod- ify and regulate direct primary care in Wisconsin. There are already a growing number of successful DPC clinics in the state, like Solstice Health in New Berlin and Dr. Suzanne Gehl in Delafield, and we want to build consumer confidence in the DPC model by formally regulating these clinics. We've crafted this legislation by working closely with the Department of Health Services, as well as health care providers throughout the state, and have the full sup- port of Wisconsin doctors through the Wisconsin Academy of Family Physicians. There's been a sixfold increase in DPC clinics in the United States since 2014, with about 3 percent of doctors nationally prac- ticing under this model. So far, twenty-three other states have direct primary care defined in their laws, including other Midwestern states like Indiana and Michigan. Recently, the federal Department of Health and Human Services announced that they will be working with states this year to incorporate direct primary care into their Medicaid programs. That's why this legislation also directs the DHS to study how we can best incorporate direct primary care into our own Medicaid system, and to craft a pilot program that we hope to imple- ment as soon as next year. Direct primary care is one of the most promising solutions toward tangibly improving patient access to health care, achieving better patient outcomes, and real- izing tremendous cost savings. There's incredible momentum behind direct pri- mary care at the state and national levels, and we need to be sure to capitalize on this opportunity to keep Wisconsin at the fore- front of health care innovation. (State Rep. Joe Sanfelippo represents the 15th Assembly District, covering parts of West Allis and New Berlin.) Direct primary care: The doctor will see you now Good ethics makes good business Torinus

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