Flu cards just tip of functioning health-reform iceberg

WHAT IT MEANS AND WHY IT'S IMPORTANT — There currently are about 1,200 retail clinics and more than 100,000 certified immunizing pharmacists. Expect those numbers to rise steadily as other employers looks to mimic Citi's free flu shot card program -- and you can bet they will.

(THE NEWS: Citi's flu care card pushes employers toward lower-cost retail channels. For the full story, click here)

Why? Finally, payers are starting to get it. And that means you can expect some pretty radical changes in the way health care is delivered in the United States.

The reality is that it is cheaper for an employer simply to give its beneficiaries free flu shots administered in a community pharmacy or a retail clinic setting than it is to allow its employees to pick up part of the bill to receive that same shot in a physician's office. It's the same vaccine.

According to analysis compiled for Citi by an outside consulting firm, in 2010, the average cost of a flu shot administered to one of its employees in a physician's office cost about $80. Even if Citi's employees paid a co-pay of $25 or $30, Citi was stuck with paying $50 or more for a shot that now costs the company about $30 apiece, even if it asks its employees to pay absolutely nothing.

At the end of the day, this is about driving down cost and realigning incentives to put more of a focus on preventive care. Flu shots cut down on absenteeism and reduce the impact of "presentee-ism" (i.e., the massive drain on productivity that occurs when sick employees come to work), which add up to even more critical health-cost savings downstream.

Research has demonstrated that healthy workers who received flu shots reported 43% fewer sick days in the average year versus unvaccinated workers. They also reported 25% fewer cases of upper respiratory infection in a typical cold-flu season. The bottom line: workers who get flu shots save their employers about $46 a year in total healthcare costs. Getting flu shots at pharmacies and retail clinics brings the cost of the flu shot down more than 60%.

That's the kind of math that is going to make health reform work.