As General Electric's director of health services, Robert Galvin was the guy responsible for managing the health insurance costs of about 150,000 employees. The job wasn't easy ? and, about five years ago, Galvin stumbled on some data that helped explain his challenges. "I looked through all our contracts and the data, where we were spending $1.5 billion on health care," Galvin, now CEO of Equity Healthcare, remembers. "One percent of those payments were based on value. The rest was just pure volume." The problem Galvin ran up against is one that is endemic to health care. For as long as we've had a health-care system, insurers have paid doctors and hospitals a fee for every service they provide.
