More than 100 of the nation’s largest employers have learned what QuadMed has learned — that primary clincis can dramatically reduce health costs, while improving health. The New York Times reported that 250 will have created their own clinics by yearend. QuadMed, as reported in my book, brought in an outside auditor to get a fix on how they were doing for costs. Eureka, they were below the national average by one-third. Two major factors enter into the positive results: the primary doctors become very serious about treating chronic diseases, like diabetes, and thereby keep people out of very expensive, very dangerous hospitals. Two, the employers now have control of the front end of the medical non-system. Medical corporations have been buying up physician clinics so they can serve as conduits to their expensive specialty based systems. It’s an attempt to control the market. Employer-owned clinics foil that strategy. Even smaller companies like Serigraph can mount small, parttime on-site clinics. We use a retainer doctor parttime, and it works great. He is as serious about chronic disease management as we are. We are aiming for zero diabetics out of control in their regimens. And he sends our people to “Centers of Value” for secondary and tertiary treatments. Those are the facilities with the best track records for quality, service and price. We are back in control. So are the big corporations who have followed the lead QuadMed set 20 years ago, like Toyota, Pepsi Bottling, Sprint Nextel, Northwestern Mutual Life, MillerCoors, Briggs&Stratton, Credit Suisse and Florida Power&Light. A final note: the clinics pay for themselves in primary care savings alone, such as avoidance of costly emergency rooms.