Michael McBride, CEO of nursing-home operator HMR Advantage Health Systems of Easley, South Carolina, says in years past he relied on data provided by insurance brokers that was cumbersome and not as easy to understand.

"They were just basically a messenger for the carriers with no efforts made toward claims management," McBride says. "I just knew we couldn't sustain 18 to 19 percent increases a year when the revenue stream was going up 3 percent a year."

Like Dickey, McBride turned to WellNet.

Using pharmacy-claim data, WellNet identified 379 of 1,900 HMR employees as high- or moderate-risk for health problems. A high number were identified as having high blood pressure and other health issues. With their permission, WellNet's nurses reached out to 132 of those employees and found some were not taking prescribed medicines or following up with doctors about medical issues.

WellNet lowered McBride's company health costs by $1.8 million from the year prior by changing employee health practices through counseling. The savings came from fewer visits to the hospital, especially the emergency room.

WellNet found a way to save money on employees' prescription-drug costs too. It studied HMR's drug spending and found the cholesterol drug Lipitor was costing the company on average $466 per employee each year. So WellNet suggested that HMR try switching employees over to an older, cheaper drug by offering to pay for that medication for three months. Twenty of the 48 Lipitor users ultimately converted to the cheaper medicine, which will save HMR around $5,000 a year. WellNet says there are at least 30 other drugs HMR employees are taking that can be replaced with cheaper or generic alternatives.

"We're self-funded. The only way you can control costs is through reduced claims or manage the claims you have," McBride says. "Our attempts are to drive people to more healthy lifestyle with some coaching and managing."

WellNet President Keith Lemer says top managers should get involved with health care oversight. Chief executives and chief financial officers understand the economics of ordering paper better than they understand major expenses like health care costs.

"If they want to control it, they have to take control," Lemer says.

Dickey concurs. "I could immerse myself in office supplies, and in 15 minutes I could have a knowledge about that," Dickey says. "It's a simple thing to jump into. But understanding health insurance is different."