Given the scope of the big healthcare debate that has transfixed the US for years, have you ever wondered where the future might really take us?

It’s now the year 2020 – let’s look back at the last decade to see what happened in the world of healthcare. What were the real long-term transformative trends that would provide for real change, real opportunity, real growth and real solutions?

The System Went Upside Down
By 2020, we had successfully transitioned the healthcare system from one which “fixed people after they were sick” to one of preventative, diagnostic medicine–treating them for the conditions we know they were likely to develop.

This simple reality, though vastly complex from a scientific, methodology and implementation perspective, resulted in a dramatic shift in healthcare philosophies, a major transition in spending, and an overall improvement in the lives of ordinary citizens.

This was the big transformative trend of the decade, and its impact was powerful and massive.

Customer Service Became The Number Two Mission
The number one priority today, of course, remains ensuring patients receive top-notch, first-rate healthcare. But the revolution in healthcare service delivery really came about when retail, consumer and branding experts took over a good part of the healthcare delivery infrastructure.

They overhauled and rebuilt the entire philosophical underpinning of the system, so it was customer focused, friendly, fast, subject to expectation metrics—service delivered with a smile! Suddenly, patients came to realize their healthcare system was no longer stuck in an adversarial 19th or 20th century model. It had come to meet the standards delivered by every other industry. The concept of “service” re-energized staff, provided for streamlined operations, and allowed for innovation to flourish.

The Top Revenue Source For Silicon Valley Is Now Healthcare Related
By 2008, most CEO’s in the healthcare sector came to realize that the real opportunity for fixing the system lay in aiming the technology–innovation engine straight at the massive healthcare problems that were then so evident. People began talking about Health 2.0—and a world in which technology would play a massive role in the revitalization of the system.

Looking back, the results of their innovation efforts were astounding. They launched new products, new business models, scientific discovery tools, bio-informatics platforms providing the foundation for diagnostic medicine, and many other incredible items. When Silicon Valley got involved in a big way, everything changed.

Bio-Connectivity Reinvented The Concept Of Hospitals
Our medical system at the earlier part of the 21st century looks rather primitive in retrospect. Expensive hospital beds stuffed full of non-critical care patients being closely monitored by medical personnel. Pure waste. Yet it was the rapid emergence of thousands of different bio-connected devices like home healthcare medical monitoring, and diagnosis and treatment devices, that provided  a renaissance in rethinking as to just what constituted a healthcare facility or hospital. Today, of course, a good proportion of both critical and non-critical care patients receive healthcare at home. We’ve transitioned to a ‘virtual community caregiving strategy’ which has resulted in cost reductions and a refocus of critical healthcare spending.

Not to mention a far more comfortable experience for the patient.

High Velocity Change Became “The New Normal”
It’s hard to believe that as recently as 2010, hospitals continued to speak of the benefits of the elusive electronic health record–yet so few had actually gone down the path of implementation.

Today, of course, most medical professionals have their 239th generation iPad at their side, are interacting with labs, medical libraries, their social-network-specialists peers and other knowledge-network peers, and continue to drive change forward at a furious pace. We now know the first of the Gen-Connect generation who graduated from medical colleges in 2010 were the catalyst that drove massive, fast and furious rates of innovative change throughout the healthcare system.

The Triumph Of Device Intelligence
By 2020, most of us found that our “personal area network” included much more than our MP3’s, video players and other digital content: it included huge chunks of intelligence from our daily health interactions. With that trend, the role of medical packaging transitioned from being a passive protector of the product, to becoming an active component of the overall effectiveness of the particular medication. Today, a typical prescription bottle now comes with an embedded RFID tag linking it to the Internet, as well as efficient bio-sensors, with the result that doctors are now provided with an instant, concise summary of the current status of a patients particular medical condition.

Computational Analytics Allowed Us To Rapidly Refocus Resources
By 2010, we came to realize that many of society’s deepest problems had a fairly decent chance of being solved by processing complex analytical algorithms with massive computing horsepower. We aimed our innovation engine at energy, ecological and healthcare challenges, and the results were staggering.

Looking back, it allowed for a significant shift in thinking. For example, while today we accept the healthcare location intelligence professional as an integral part of the hospital team, back in 2010, they were but a rare anomaly. Back then, no one believed it would be possible to link the
massive amounts of information found in the global ‘data-cloud’ to the rapid emergence of particular medical conditions.

Today, of course, most healthcare facilities use the insight of such professionals to regularly track, monitor and devise proactive plans to deal with new emerging healthcare challenges. We’ve come to link massive subsets of data to geographic insight, allowing us the ability to better plan, manage and deal with complex circumstances.

We Adapted To Faster Science Through High-Velocity Structure
We can now look back at the period of 2010-2020 as an era of profound change when it came to medical innovation.

Given the fast pace of discovery of new medical knowledge, we witnessed a massive acceleration in the number of new medical procedures and treatments, pharmaceuticals and bio-materials, medical technologies and devices, diagnostics and methodologies.  We came to realize that it was our ability to rapidly ingest new knowledge that became a key savior in our re-engineering of the concept of our healthcare; it was our speed of action that defined our success.

We Transitioned To A Medical Culture Of “Just-In-Time-Knowledge”
Given the constant doubling of medical knowledge in ever shorter time spans we came to know the system could no longer function based on an antiquated model of one-time knowledge delivery.

Medical schools adapted, providing for the “velocity” of knowledge that was required by ever more rapid scientific advance. They knew a big change was underway, as is now evident. It is now estimated that in 2020, the average doctor and nurse refreshes their entire knowledge base every 18 months.

The result was that the relationship between medical colleges and students changed, from a period of short term, concentrated knowledge delivery, to one of  lifelong, ongoing replenishment and rejuvenation of knowledge.

We Rose To The Challenge
In 2010, we were morose; we had no belief in the future; wracked by economic self-doubt, we came to believe that the healthcare system would continue to crumble. And yet, what happened next was fascinating. The youngest generation–faced by a health system bankrupted by massive demand from the baby boomer generation in their retirement years–focused their energy on transforming the system.

There was an awakening that they could turn their attention from sharing quick-knowledge hits on now-defunct networks like Facebook and Twitter, and instead, heed a greater call to action. They aimed their minds towards one of the deepest challenges of our time and turned on their innovation engines. And as we know now, that was a truly transformative moment.

Jim Carroll is an international futurist, trends & innovation expert, providing insight to a vast range of Fortune 1000 organizations and associations. Comments welcome at jcarroll@jimcarroll.com.

No CEO can afford to ignore the smartphone technology trend that is changing everything about how we do business. According to recent Morgan Stanley research, mobile internet is ramping up much faster than desktop internet did and is projected to outpace it in the next five years. It is coming on faster than any previous technology has, so you can either choose to develop a strategy and use this opportunity to your advantage, or you can fall by the wayside as your competitors take the lead.

A Changing Landscape
New Business Models – Smartphones are changing the way companies do business in a number of industries. Carriers, for example, are looking for ways to keep up with the new bandwidth requirements. Despite these changes, however, smartphones have actually led a regression back to client-server models. While the web enables users to choose whatever browser they want, companies that develop software apps have to offer one for each specific phone. In a recent article, Larry Dignan notes that mobile devices are “hamstrung by primitive business models.”

New Marketing Models – With GPS tracking and location-aware technology, advertisers can offer deals based on where the user is at any given time. For example, Groupon is a growing company that offers special promotions contingent upon a certain number of people signing up for them. The company now has an app that uses GPS tracking to determine where a user is and then offer “groupons” for that area. All one has to do to see the value in this new model is look at the success of Groupon – it was recently valued at $1 billion and the founder and CEO has said that there are hundreds of businesses on the waiting list to get involved.

How You Should Respond
New technology is always scary, especially when it impacts your business. You have two choices in how you respond – either let it overwhelm you or embrace it and figure out ways to create new revenue streams. With the former, you run the risk of not only losing out on new opportunities, but of being put out of business altogether. Remember how web-based solutions annihilated packaged software systems that only worked on the PCs they were installed on? History does and will repeat itself, so smart CEOs will learn more about this technology and try to figure out ways to make their customers more successful.

B2C Strategies – B2C companies such as Amazon.com and eBay have developed apps so that users can access their services easily and effectively on their smartphones. In addition, social networking tools like Twitter and Facebook are maximizing mobile technology potential as well. Foursquare, the newest social media sensation, uses GPS tracking to enable users to “check in” at various venues in their city, letting friends know they are there, offering recommendations on what to buy, and racking up badges that can get them discounts from local vendors. Other B2C companies can use this to their benefit by developing applications that offer hours, promotions and other key information to users.

B2B Strategies – Innovative B2B companies are also broadening their offerings to include this new market. Austin-based RFG, Inc., an employee engagement and advisory firm, is one example. RFG has created an application that will provide access to an employee’s health records on her smartphone. This means that visits to the doctor will be simplified dramatically as users search through their records to answer questions on health forms. Such an offering gives them a competitive edge over other companies because it enhances the user experience.

Creating Your Strategy – The most important part of creating a mobile strategy for your business is knowing your audience. Understanding the needs and desires of your potential customers is the only way to create mobile solutions that will resonate with them. Recruit people throughout your organization, specifically ones who interact with your customers, and brainstorm ideas on the kind of problems you can solve with new technology. Is a specific problem the Achilles’ heel of your industry? Come up with ideas on how to be the first to fix that problem for your customers.

Consider a certain popular burger restaurant here in Austin, Texas. The restaurant has a flash website that is very attractive when viewed on a desktop computer. Yet if a potential customer is in the area and wants to find out menu, pricing, location or hours information on her mobile device, it is impossible. Most mobile devices do not yet support flash. Likewise, you do not want to miss out on business opportunities by ignoring the practical needs of your target audience.

Our company, Journyx, provides web-based time tracking and project management solutions, and we are currently working on developing these applications for smartphones. Imagine how location-aware technology can simplify time and project tracking by suggesting that while you are in a certain location (e.g. at a client’s office), you are most likely working on a particular project or task. After 14 years of working with and listening to our customers, we know that they can benefit from this type of technology.

Time for a New Game Plan
Smartphones have taken the world by storm and businesses that want to stay competitive cannot afford to ignore them much longer. Whether your target market is consumers or other businesses, you will need to find a way to accommodate the growing user experience by developing a wireless mobile strategy. Once you see how profitable it can be and how jealous your competitors are, you will know that you have made the right choice.

Curt Finch is the CEO of Journyx, an Austin-based provider of web-based time tracking, project accounting and resource management software designed to guide customers to per-person, per-project profitability. April Boland is their Resource Manager.

Dear CEO,

A lot of rumors are going around that Gen Y employees are unreliable, lacking in ambition, and even just plain lazy. I know most companies can find many examples of these stereotypes in their work force, so I won’t try to argue that these allegations are unfounded.

I think it is important to realize that these less than favorable attributes are not simply the product of poor breeding or a generational inclination towards mediocrity. Rather, these are the results of not being properly motivated. I realize that you think you are doing everything you can to motivate young employees. However, if you want to get the most out of your young employees, you need to give a little to in order to get a lot.

I know you’re probably thinking, why should I go so out of my way to make young workers happy? I worked my way up, what makes them so special? Why won’t they do the same?

Simply put, the game has changed. Even 30 years ago there was some reasonable assurance that if you worked hard at a company you’d continue to move up and eventually retire from that company with a pension. To my generation this scenario sounds about as plausible as the Easter Bunny. Most of my generation expects to switch jobs multiple times throughout our lifetime. Once appalling to hear of a company laying off employees during a merger, after decades of loyal service, now this news is common, if not expected.

How motivated would you feel to “pay your dues” at a company you strongly believe will fire you at some point, even if you have done nothing wrong?

Moreover, they might fire you even if you are a great employee, doing an amazing job, just because they need to balance the books one fiscal quarter. When you consider the workplace from our point of view it is easy to see why we are lacking motivation. The incentives of job security, consistent promotions, reliable raises and retirement are no longer in the equation. So if you want motivated young employees you must provide new incentives.

What are some changes your company can make to motivate young employees and keep them performing at peak levels out of respect and admiration for their company?

1. It is important to be willing to re-evaluate many aspects of your operation to consider if they are still valid and necessary. For example, when much of our work can be done online, it seems silly to expect us to be at work at exactly 9 a.m. We have to fight traffic which makes our 15-minute commute take over 45 minutes, just so we can sit at a company desk and do the same work we could have done on our own laptop.

2. You need to learn and understand our values. As a generation we are fiercely altruistic. It is not uncommon for many of us to have spent our entire summer volunteering to help the less fortunate. If you incorporate a significant and visible outreach program into your company you will quickly gain the respect of your young employees.

3. Make young employees feel they are an important part of the organization. Most companies still function on a pecking order system, where new employees are made to feel their opinions are not valued. Instead, form a system where employees at any level are encouraged to contribute ideas to better the company. This helps your young employees feel engaged and validated.

4. Let your employees know you care about their future. This can actually be accomplished quite simply through free educational programs. Teaching young employees how to manage their finances or how to successfully network in business communities will help young employees feel their company cares about their future. As an added bonus this education will also make them better employees.

If you take the time and focus on motivating your young employees, I think you will be amazed to see just how capable and productive we can be. After all, we are a generation that had full schedules in the first grade that included multiple after-school activities. Moreover, we have had more straight “A” students than any previous generation and more college graduates. We are most companies’ greatest assets, if they could just take the time to understand how we think.

Respectfully Yours,

Gen Y Collectively

The U.S. Supreme Court’s recent decision in Citizens United vs. FEC overturned over a century of campaign finance law by opening the door to increased corporate involvement in American politics. The ruling was instantly celebrated by some commentators as a welcome victory for First Amendment rights and maligned by other commentators (including President Obama) as a threat to representative democracy. Passions aside, Citizens United is a noteworthy legal ruling which significantly alters campaign finance laws for corporations at both the federal and state levels.

Corporations here in Texas are especially interested in how the ruling impacts our state’s campaign finance system, and what changes they can or should make to their Texas government affairs programs in the midst of the 2010 Texas election campaigns.

Initial forecast: The Citizens United ruling may be passionately debated by legal scholars and political pundits for years to come, and it may have a significant impact on federal politics, but it is not likely to dramatically change the role of corporations in Texas elections in the near future.

The lawsuit in Citizens United challenged the constitutionality of federal and state laws that have historically prohibited corporations (and labor unions) from “electioneering.”  Electioneering is the expenditure of money on campaign activities, for example, the running of campaign advertisements for or against a political candidate. Texas has long had very strict laws against corporate electioneering, requiring corporate executives to donate their own personal money to candidates or to political action committees.

In Citizens United, the court struck down all such laws nationwide as unconstitutional restraints of First Amendment rights, thus permitting corporations (and unions) to spend freely on political advertisements for or against candidates. As a result, corporations are now relatively free to electioneer in Texas campaigns. For example, ABC Corporation may now spend unlimited amounts of its treasury funds to run advertisements for or against a political candidate: “Representative Doe is a True Texas Hero; Reelect Representative Doe in November,” or perhaps “Representative Doe is bad for Texas; Vote against Representative Doe in November.”

It is important to note that the court’s ruling did not overturn all Texas or federal restrictions on corporate political activity. Corporations are still prohibited from contributing directly to a candidate’s campaign coffers. Corporations are still prohibited from coordinating the timing or content of their electioneering efforts with a candidate. Corporations are still required to publicly disclose their electioneering expenditures and include identifying disclaimers on their political advertisements. Most importantly, violations of these laws can still result in criminal prosecutions. So if corporations decide to step onto the campaign field, they should tread very carefully and consult with election law experts.

We represent a number of corporations and trade associations who are active at the Texas Capitol, and interact on a regular basis with many more. Our initial observation is that contrary to conventional wisdom most Texas corporations are not wildly celebrating the Citizens United ruling, nor are they hurriedly making plans to jump into the political fray. We find that most Texas corporate executives already cringe at the amounts of money they spend on government affairs (though trade associations, lobbying and political action committees) and do not particularly relish an “opportunity” to spend more. Most Texas corporations have no interest in inserting themselves into the rough-and-tumble of Texas political campaign advertising.  Moreover, most corporations are probably not eager to explain to shareholders and consumers why they spent big money supporting Representative Doe over Representative Smith.

In addition, recent voter surveys show that following a long run of corporate scandals and financial bailouts, Americans’ trust in corporations is at an all-time low. In this environment, Texas political candidates may not welcome the “support” of a campaign advertisement that ends with a corporate disclaimer. (“This ad for Representative Smith paid for by Megacorp, Incorporated.”)

We in Texas will probably see an occasional corporate advertisement supporting or opposing a candidate. But the vast majority of Texas corporations will continue the traditional — and relatively safe — government affairs package of lobbying and personal giving through political action committees and will say “thanks but no thanks” to their new opportunity to engage in corporate electioneering.

Gaylord Armstrong and Royce Poinsett are government relations attorneys at the Austin office of McGinnis, Lochridge & Kilgore, L.L.P.

A true story – on July 19, 2009, a man in New Hampshire went into a gas station to purchase a pack of cigarettes and was charged $23,148,855,308,184,500 on his debit card. When he saw the stunning 17-digit number he called his bank to sort out the problem and to eliminate the $15 overdraft fee. To his chagrin, it took over two hours on the telephone to convince the bank employee the cigarettes did not cost $23 quadrillion and he should not be charged the $15 overdraft fee. The bank finally corrected the error…the next day!

Although this is an oversized example of a transaction gone haywire and a double dose of bad customer service, it is also an example of something that’s wrong with businesses today. Employees are afraid to rectify customer service issues because they are worried about the repercussions if they make a mistake. What would your colleagues or staff have done in a similar situation?

What the bank employee should have done is instantly correct the error. The bank should have taught their employees that no one will ever be punished for using good judgment and common sense when trying to accommodate a customer’s needs, no matter what the rules are.

So what can be done to improve customer service? Retain your customers by delighting them. Here are two tools to begin the journey to delighting your customers.

Tool One…See Yourself as a Service Provider
You don’t just sell a product, you sell a service. For those in healthcare, you don’t just provide medical care, you provide comfort, ease of mind and knowledge – along with the ability to treat and cure illness. No matter how accurate your diagnosis might be, if it’s delivered in a way that confuses or in some instances alienates the patient, the patient won’t be delighted and might not follow your directions leading to a lack of compliance. Ninety percent of patients change doctors because they feel the doctor is aloof, abrupt, inattentive or evasive.

Every person in your employ must realize that being a service provider means that each and every one has the ability to assist customers in delivering uncompromising service – and that begins with your leadership and clear communication.

Several years ago my wife became paralyzed, and she sees a neurologist for check-ups. At the scheduled appointment time we went to the doctor’s office. After 30 minutes we were still waiting to be called. After speaking to the receptionist, she told us she would find out why there was a delay in seeing the doctor. After another 30 minutes had gone by, still no answer about the delay. The receptionist got angry because I was asking why the long delay with no explanation. We left the office without seeing the doctor. Later there was a call from the doctor’s office to apologize for the receptionist’s behavior. My wife now sees another neurologist, one that empowers their staff to communicate clearly and is patient friendly.

Being a professional service provider means the customer’s needs take precedent over almost everything else. Your staff will watch you to see how you treat the patient, and they will follow your lead.

Tool Two…Create an Adaptable Environment
Learn how to change based on the needs of your customer. If your client asks for something and the request is reasonable, consider the request. In the example above, the receptionist should have found out how long the delay was going to be, provided an explanation and offered alternatives such as…continue to wait, reschedule the appointment, perhaps even offer lunch while we waited.

Be flexible and honor requests when it makes sense. If you wait for the customer to provide solutions, you often won’t like the options. Before the situation gets out of control, provide choices – they ease customer’s minds and provide your clients acceptable solutions to problematic issues.

Delivering customer delight is an on-going journey and the journey never ends. If you deliver delight customers will return again and again.

Steve Zipkoff is the President/CEO of Zipkoff Solutions, and an Adjunct Professor at the SMU Cox Graduate School of Business in Dallas.

A three-year-old boy waiting to see a doctor at the Children’s Wellness Center in Del Valle looked bemusedly at a small book in his hands. Like other children who come to see a doctor at the center, he had been given the book before his examination. He turned it over and over, looked at its back and front covers, but didn’t open it.

“He had never seen a book before,” said Dr. Karen Haslund, the center’s director.

Another little boy, about the same age, smacked the cover of his book with his fist. It was his way of telling his mother that he was interested. She took the book, and started reading to him.

“He’s gonna be all right,” said Dr. Haslund.

Haslund uses children’s reactions to books as an easy diagnostic test, to determine whether they’re on track for developing the skills they need to learn to read. Del Valle, southeast of Austin, is an unincorporated rural and suburban area with a large Hispanic population. She sees a lot of children who have little or no experience with books. So Haslund, along with 26,000 other doctors and nurses around the country, is part of “Reach Out and Read,” a non-profit organization that enlists doctors to promote reading.

Each examination room in the Wellness Center has a cabinet of books hidden by curtains. But a small rack next to the examination table holds several books, deliberately placed so children will find them. With luck, the child’s parent will read to the child, and after the examination, the child gets a brand new book to take home. If the child’s brother or sister comes along, even if they don’t see the doctor, they’ll get a used book of their own.

“For many of these kids, the book is the only new thing they get all year,” Haslund said. “It’s a pretty big deal for them. They keep them in their backpacks, so their brother or sister can’t get at them.”

Haslund would like to see at least five to ten books in the home. That way, reading aloud has a better chance of becoming a family activity. Right now, one-quarter of Texas households have fewer than ten books, and according to Reach Out and Read, Texas ranks 49th in the percentage of children under age five who are read to daily. Reading aloud is one of the best ways to increase a child’s vocabulary. “If you don’t get to kids in the first three years, they’ll have been exposed to a million fewer words than kids who are read to,” Haslund said. “They’re already behind.”

Take the case of Jasmine, whose 15-year-old mother brought her into the Center. When Haslund presented her with a book, and explained the importance of reading aloud, the mother said, “I didn’t know you could learn before you went to school.”

“Man,” said Haslund, “that kid is toast.”

The problems of illiteracy are well known in the work place. The Literacy Coalition of Central Texas says 20 percent of Central Texas adults can’t read well enough to fill out a job application. Across the country, businesses spend more than $60 billion each year on employee training, and remedial reading gets a good share of that.

“I want the person on the assembly line to be safe,” Haslund said. “I want the janitor to avoid using dangerous chemicals.”  When employers have a literate work force, they can grow them in other ways, too, Haslund said.

With The U.S. Department of Labor reporting that six of the ten fastest growing jobs require an associate’s or bachelor’s degree, getting children familiar with books and reading early is an easy way to make sure they’re ready to join the work force when they grow up. “The infrastructure is already there,” Haslund said. “It’s efficient and cost effective.”

By David M. Kniffen

Author:  David M. Kniffen

Some years ago, an acquaintance who became a friend confided to me that he is a recovered alcoholic. He held significant standing and was considered one of his firm’s best young lawyers. I was forever left with the impression that addicts are among all of us, and they are oftentimes the most valued assets of our organizations.

Chances are good an asset to your company is an alcoholic or substance abuser, will become one, or is in recovery. Chances also are strong you don’t know this person has a problem. Substance abuse has long drained resources from workplaces and destroyed families, but the good news is research has yielded adoption of advanced, science-based treatment approaches and new recovery support technologies that can enhance Employee Assistance Programs, effectively helping employers heal and retain valuable employees as well as assist their families. At the core of these advances is a growing understanding and recognition that addiction is a chronic brain disease.

Although some longtime and dedicated providers have helped countless addicts, experts say the industry failure rate exceeds 70 percent. The historic inability to effectively treat addiction is rooted in the long-held belief that addiction is a moral sin or behavioral problem, few recognize it as a medical condition, and the ‘traditional’ approach demands treatment be completed in about a month – a number figure set by insurers that researchers agree is not nearly long enough. Most programs are one-size-fits-all that vary from provider to provider, clinic to clinic, counselor to counselor – there is no one approach that is standard much less improved upon.

Society’s view of the addict has also held back advances in treatment. For too long, most addicts have been viewed as weak, non-productive members of society, but today ignorance is fading as many now understand addiction is prevalent across all layers of people, including our most highly regarded professionals. A large number of substance abusers began ‘by accident’ through overuse of painkiller drugs for chronic pain or drinking at the end of the day to ‘take the edge off.’

Substance abuse is pervasive, deadly and expensive. Alcoholism alone is the third leading cause of death in the United States. State and federal governments spend more than $15 billion per year, and insurers another $5 billion more annually, on substance abuse treatment services for about four million people. Researchers estimate that some 20 million Americans who could benefit from treatment are not getting it, but passage of the mental health parity law in January will help as addiction treatment under federal law now requires insurers to cover mental and physical ailments at the same level. And these cost estimates don’t include what businesses spend for insurance coverage and programs to manage risks and limit exposure from accidents and mismanagement problems.

The good news is strong scientific evidence clearly identifies addiction as a chronic brain disease, and a select number of treatment providers are employing advanced, science-based approaches. Advanced providers offer dual diagnosis, which identifies and treats not only the addiction but also other underlying behavioral issues, such as chronic depression, that can feed addictive behavior. Cutting edge medication therapies are used to help abusers overcome cravings and can help with long-term sobriety. Neurological therapies are used to help correct brain trauma caused by addictive behavior and help restore deficiencies in cognitive functioning. Critically important, information is shared with addiction scientists to further improve treatment practices, as is common among those who treat any type of disease such as cancer.

Another significant development in substance abuse treatment is use of technology to sustain recovery, including online recovery tools employers are offering as a vital component of their Employee Assistance Programs. Online eSessions are helping people utilize the most advanced addiction behavior modification techniques across all phases of recovery, can be administered and monitored by the patient’s therapist, and is filling a critical gap in recovery for those who live in areas without adequate therapeutic or group support. The program elements described have recently been adopted by the Baylor Health Care System as a component of its Employee Assistance Program, which is provided to its 20,000 employees in North Texas. We expect the industry to increasingly embrace technology to reach more people in need of help.

David M. Kniffen is the president of Enterhealth, an addiction disease management company located in Dallas, TX.  He can be reached at dmkniffen@enterhealth.com.

1. Pay attention to basics like data, design, financing, compliance, communication and representation. A holistic approach to these fundamental elements may reduce costs and headaches.

2. Many employers are entitled to details of their own claims history. Find out how paid premiums compare to paid claims, and whether there are any large claims ongoing. This information is critical for both budgeting and the bidding process as insurers base pricing on these numbers.

Innovative benefit design. There is a common misconception that increasing deductibles and co-pays is a negative step. In truth, benefits that are too rich result in premiums that are too high. Low co-pays were introduced in the ‘80s for HMOs, and only the entitlement mentality remains.

Consider High Deductible Health Plans (HDHPs) as an option alongside conventional PPOs. Many people assume that HDHPs and Health Savings Accounts (HSAs) are synonymous. In fact, they often overlook Health Reimbursement Accounts (HRAs), which may be an even better cost reducing option for employees of average means.

5. Limited Benefit Plans make sense for very low paid workers or for industries with high turnover. These particular plans are changed under the new law, but properly designed, they offer great potential for reducing employer costs and providing an affordable benefit for those who would otherwise be unable to pay for coverage.

With creative reinsurance protection, smaller employers can now take advantage of self-insurance options, once only reserved for large employers. Businesses with healthy populations and the ability to bear risk may benefit greatly from improved cash flows and lower ultimate cost.

7. Communicate actively with employees and their families about their benefits. Let employees know the value of the care and expense you are undertaking in providing this vital non-cash compensation. Take steps to let them know about the availability of preventive care and generic drugs as examples of steps they may take that save money over time.

8. Choose the right broker that is up to speed on legislative and marketplace changes. He or she takes the time to understand your business and work in support of your business goals. Commissions should be disclosed to you, along with other incentives and rewards they are receiving from insurance companies.

Mario Di Blasi, CEBS, is Vice President of Employee Benefits for Apex Global Partners, Inc., an insurance and benefits brokerage firm and is located in Austin, Texas

There are three components of the fraud triangle: incentive, rationalization and opportunity. With few exceptions, people engage in fraud because they have a reason that’s related to either money or ego. And because most employees realize fraud is wrong, they convince themselves what they are doing is really not fraud–they rationalize their actions because they are either “deserving” or they are only “borrowing.” Incentives and rationalizations are outside your sphere of influence and, as such, cannot really be changed.

Your organization, however, can affect opportunity by instituting internal controls to help protect your assets and prevent loss exposure. Internal controls can range from the simple, such as locks on the doors and taking daily cash deposits to the bank, to the sublime with 24/7 video surveillance and retina scanning devices to access the inventory warehouse. Most businesses opt for something in-between because of personnel and monetary constraints.

Three of the best methods to reduce the potential for fraud are nearly free, or free.

The first simple and effective internal control is separation of duties: simply don’t let one individual have total control of all activities in a specific organizational function. Someone who has both an incentive to commit fraud and the ability to rationalize the action probably doesn’t want others to know what they’re doing. So, putting someone from another department in the job process, or reassigning duties within your organization, typically limits the opportunity to commit the fraud.

The second internal control is even easier than the first, since the only thing you need to do is to pay is attention by listening and observing. Simply listen to what people say, and look at what they do. New homes, new cars, new wardrobes, or exotic vacations with no change in an employee title, status or pay might be reasons to attempt to gather additional information. Other things to you need to watch for?  Behaviors like consistently staying late at work, not taking vacations, lamenting financial difficulties, and avoiding company colleagues or get-togethers are all signals of rationalization.

The last easy and inexpensive internal control is making certain your staff understands the importance of whistle-blowing and is encouraged to speak up if they believe anything fiscally inappropriate is occurring in the organization. The Association of Certified Fraud Examiners (ACFE) has consistently shown that most frauds are found not by auditors (internal or external) but from tips by employees, customers and vendors. If a whistle-blower hotline is too expensive for your operation, you should make sure all your employees understand that “telling” is good and a variety of individuals (including internal auditors, if they exist) should be designated as those with whom issues can be shared confidentially.

Fraud surrounds us and, according to ACFE, costs the average U.S. business about seven percent of its annual revenue each year.  When your business loses money to fraud, everyone loses. The prices of goods increase and the potential for job losses from business closures also rise. There are many industries where that seven percent is the difference between profit and loss for the year.

While fraud will never be eliminated in businesses, it can often be reduced through an “open” perspective. Open your activity loops: separate duties to prevent total control by a single individual. Open your eyes and ears: listen to what people say and watch what they do to garner clues about changed or changing circumstances. Open your mouth: vocalize the benefits of providing, and reward those who provide information about wrongdoing. Being more open will, in fact, help close the door on organizational fraud.

Cecily Raiborn, PhD, CPA, CMA is the Endowed Chair in Accounting for the McCoy School of Business at Texas State University-San Marcos

They’re talking about you. The conversation may be about your company, your product and your brand, or maybe even about you personally.

Who are they? They’re your customers, clients and potential consumers. And the talking that they are doing is taking place right this moment on a variety of social media applications on the Internet such as Facebook, Twitter, LinkedIn and YouTube.

We’ve all been to a cocktail party or event where someone tells someone else about the good or bad experience that they’ve had with a product or a service. Think of social media as that party or event on a massive dose of steroids. Unlike that event, the conversation is available to future consumers and clients forever, via the Internet.

Social media has created social influence marketing, defined as the role that consumer generated media plays in purchase decisions. The interactive agency Razorfish found that 71 percent of the population has shared an online recommendation for a product, service or restaurant in the last few months. Online applications such as Yelp, Foursquare and UrbanSpoon are leaders in this arena. Like it or not, there is a conversation going on about your brand, your product and your service right now!

Perceptive brands, led by many of the Fortune 500, are joining the social media conversation. Ford recently announced a commitment of 25 percent of its 2010 traditional ad budget to interactive and social media. Pepsi took $20 million reserved for Super Bowl commercials and placed it in social media.

It has been said the Facebook may ultimately become as important as Google in the realm of “search.” Consider, if you were looking for a plumber or place to buy a flat screen TV, would you place more credence in the recommendation of a friend or a listing created by Google’s formula? If you answered “friend,” then think “Facebook” or “Twitter,” where millions of consumers have created networks of friends who are available 24/7 to respond or recommend. Google, the pre-eminent search engine, now gives first page search results from real time social media apps such as Facebook and Twitter.

Yet, many CEOs are reluctant to join the social media conversation. Most often, the reason is that “we can’t control the message,” or, “what if they say something negative about us? Well, they are going to say whatever they want, and there are no social media or Internet police that can make them stop, even if it is unfounded.

But, by actively participating in social media, you can provide realistic information in an engaging, personal and humble voice. When done correctly, this provides insight and creates even more brand loyalty among your customers.

An article in Forbes by Fraser and Dutta, “Yes, CEOs should use Facebook and Twitter” stated:

“A CEO can use Web 2.0 tools not only to communicate and learn, but also to instigate action and become a more effective leader. Tools like blogs and podcasts put a top executive in more direct contact with employees, cutting through multiple layers of middle managers, who can be motivated by their own agendas to frustrate direct communication. A persuasive CEO can use Web 2.0 tools to boost morale, foster creativity and enhance the values of open collaboration.”

Space prohibits the listing of Fortune 500 CEOs who have adopted social media to enhance their brands and positioning. Alan Mullaly, CEO of resurgent Ford, states, “Social media is the future.” Ford’s prowess and investment in social media is legendary. Each model gets its own pages on Facebook, Twitter, YouTube and Flickr. Blogs are used extensively in the sales and customer service efforts.

If you are not yet using social media, you should make it a priority to do so. If you don’t communicate your relevance in this space, your competitors and consumers may use it to communicate your irrelevance.

Mike Ventura is a brand strategist and social media marketing evangelist who has worked with Fortune 500 companies and grass roots start-ups to develop consistent brand messaging across multiple platforms.  You can follow and find him at: mikev@ventura-company.com