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Primary care model

Quad/Graphics, which opened its first clinic in 1990, has shown that. Its employees are hospitalized less frequently and for less time than the national averages, the company says. In addition, it estimates that its health care costs are about 20% lower than the national average.

The company, based in Sussex, sees over 18,000 patients a year at its five clinics. It also operates two dental clinics, two optical centers and six rehabilitation centers, with a seventh opening soon.

Quad/Graphics realized that it could not change the health care system, said Len Quadracci, a nephrologist and president of QuadMed, the subsidiary that oversees the clinics. Therefore, the company set out to build its own model.

The model, focused on primary care, links doctors' wages to meeting certain benchmarks of quality rather than the number of patients they see or the number of tests and procedures they do.

That is not the norm in the health care system. The relatively low fees paid to primary care doctors - who can make less than half of what some specialists make - means they must see more patients to maintain their incomes.

That means spending less time with patients. The result can be more office visits, more referrals to costly specialists and often lower quality care.

"It's a system that fosters waste and poor quality," Quadracci said.

Quadracci, who was on the faculty of the University of Washington for 20 years, returned to Wisconsin in 1995, to oversee QuadMed. The subsidiary now employs 247 people, including 33 full-time and part-time doctors.

QuadMed also runs clinics for Miller Brewing and Briggs & Stratton.

Quadracci said, "We are not knocking on doors. Mainly it is people coming to us.



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