Human capital is as important as financial capital, Andrew Webber said Wednesday in explaining why employers have to care about transforming health care.

Webber, president and CEO of the National Business Coalition on Health, was one of the keynote speakers at the 32nd annual Sedgwick County Health Care Roundtable.

He and Kent Seltman, an author and former chairman of the marketing division at Mayo Clinic, gave employers, insurers, providers and others advice on getting the most for their health care spending, by paying more attention to quality.

Mayo Clinic has been known for quality for more than 100 years, Seltman said.

But it's not just medical care that has produced that reputation: It is well respected because of its attention to detail, teamwork, the tools to do the job that's expected and a respect for customers, he said.

Customer service, he said, is the most important part of the branding model.

Webber said everyone wants what he called true health reform: better health, better care and lower costs.

"It's not impossible," he said, adding that employers have to be change agents — and that it's in their bests interests to do so.

"True reform gets played out locally," not in the halls of Congress, he said.

Health care costs are bankrupting governments, employers and families, even though health care is only a relatively small influence on health status, Webber said. Income, education status and behaviors play a much bigger role.

Higher costs don't mean better care, he said. For example, he noted that physical therapy and exercise have been shown to be the most effective first course of action for lower back pain — but many patients want, and many doctors order, an MRI.

If the patient demands an MRI as a first step, he said, as employers, "we should say... you're going to pay for it."

Benefit design should mirror good science, Webber said, noting that parts of the Affordable Care Act call for research on effectiveness and for spending on preventive care to head off more serious health problems.

But it's not up to employers alone. Payment reform has to reward outcomes, not volumes. The current system pays once for treatment, then pays again if there are complications or if errors are made in treatment. Instead, payments should be bundled for an episode of care, he said.

Consumers should be brought in to the equation so they know the costs of care rather than feeling an entitlement to it, he said. And consumers need incentives to be compliant with appropriate treatment: "We're too reliant on the patient to make the right decisions."