Health Navigators

Health Navigators

Ed Dillabough and John Wittorff used to head HMOs in the Tampa Bay area, so they understand the costs and complexities of providing health care.

The balance between profits and making good health care decisions was usually achieved, they say.

But they sensed something was missing in the health insurance market: A firm that could work for companies across a number of industries, gathering information from health insurers, hospitals and doctors and recommending the most cost-effective coverage and choices. In a phrase, a medical management company.

So in 2001, they created it. Dillabough and Wittorff took $200,000 of their own money, became entrepreneurs and created Delphi, a health care advocacy company in St. Petersburg.

Law firms, engineering firms, cities, manufacturers and a beer distributor in several states signed up for their service.

Delphi competes against a handful of large U.S. competitors, such as Health Advocate in Philadelphia, but only employs 10. It works for about 100 clients and their employees to find these health care values.

Delphi's nurses speak to hundreds of people daily on the telephone on how to get second opinions, how to pick a specialist and what hospital or clinic is the best to use for the best care in their town.

One finding Delphi has made: Bigger budgets don't make for better hospitals. Often, the more efficient a hospital or clinic has to be, the better the care it provides.

"Better care is less expensive," Dillabough says.

Delphi has found big cost differences.

Some MRIs cost $400. Others, $2,900. Delphi saved one CAT scan patient in Jacksonville $1,500 by finding a cheaper provider. Many employers and health care brokers are unfamiliar with these costs.

"No one knows what anything costs," Dillabough says. Part of that is because hospitals are reluctant to break out fees.

The company has also found flaws in the system, for which it tries to compensate. For example, sometimes doctors practice "defensive medicine," and order more CAT scans and X-rays than are necessary. Meanwhile, companies don't talk to their employees enough about health care coverage, so employees make poor choices sometimes.

Delphi also tracks historical data. For example, the cost of MRIs has risen seven-fold in the past 15 years in the Tampa Bay area.

Which hospitals, doctors and clinics should someone choose? That's where Delphi comes in. It matches the ailment and needs of the patient with the best health care providers. It does so with an eye on costs, which saves employers and their staffs money. Clients pay Delphi on an employee-per-month basis to assist them.

Revenues at Delphi soared 400% in 2007 and should double this year. Rob Pariseau, president of Benefit Solutions Group in Tampa, called medical advocacy "the missing link" in American health care.

Americans are unprepared for and fearful of the health care system. All too often, they make medical mistakes that lead to unnecessary suffering and wasteful spending by employees and employers.

That's where Delphi's medical advocacy program comes in, trying to help patients get the right care, in the right place, the first time.

"It's the first win/win in health care in decades," Pariseau says.

Looking ahead, Dillabough expects Delphi to have 100,000 members in about a year and about 1 million members three or four years from now.

Its vision is to help consumers be better purchasers of health care. That means knowing costs and health care services so employers and their staffs can make the right purchases.

- Dave Szymanski