BEDFORD – As the health care debate rages in Washington, some companies are taking it upon themselves to lower health care costs with their own reforms and incentives as a way to save money and stay competitive.

One company compelled local health care providers to compete for business with providers halfway around the world. The result was much lower costs and greater transparency.

Peter Hayes, director of associate health and wellness for grocery chain Hannaford Brothers Co., said that in a global economy, lowering health-care costs to compete with other nations for business is essential.

"Every corporation now is competing for global capital," Hayes, one of three speakers at a forum on how businesses can reform health care, told a crowd in Bedford yesterday. Other speakers at the event, which was sponsored by MVP Health Care, included Gary Hirshberg, CEO of Stonyfield Farm, and Tom Oksanen, the senior vice president of employee benefits at Fidelity Investments.

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The Hannaford supermarket chain is owned Brussels-based Delhaize, Hayes said. Being owned by a European company means competing with European nations for capital, he said.

While all supermarkets cost about the same to build -- around $15 million -- supermarkets in Europe return $8 million more over 10 years on the initial investment, Hayes said, because health care costs can be double or more in the United States.

The corporation recently acquired 50 supermarkets in Europe. There were 50 places in the United States where stores could have been built, Hayes said, which would have brought 10,000 jobs to the country, but they went overseas because of health-care costs.

"These were real jobs," Hayes said.

And while the U.S. has the most expensive health care among those nations it is competing with, its outcomes are the worst, Hayes said, noting that America records the highest rate of preventable deaths.

To compete, Hannaford set out to cut its health care costs in half. The first step was to promote health and wellness among employees, Hayes said, by rewarding those who stayed healthy, through incentives including smoking cessation, physical fitness and receiving screenings such as mammograms.

The rest of the savings came from what Hayes said became the company's mantra: "Once people get ill, they got the right care at the right time in the right place."

Hayes said many Baby Boomers in New England end up needing surgeries like hip and knee replacements as they continue to stay physically active as they age. One Hannaford employee had an unnecessary hip replacement and ended up with a staph infection, costing hundreds of thousands of dollars.

Hannaford is based in Maine, which has some of the highest health care costs in the nation, and hip replacements were costing $50,000. So Hayes looked into "medical tourism."

He visited Singapore, where the procedure would cost $10,000 and be done with outcomes that were just as good, if not better. All patient records were electronic and all instances of infection or other problems are made public on the Internet, he said, while local hospitals were unwilling to disclose the same information.

Local health care facilities did not feel they had to bring their costs down, or their standards up, Hayes said, because they did not believe people would go elsewhere. That, he said, "was like waving a red flag" in front of him.

The company told employees that they would pay 100 percent of the costs -- no co-pay and no co-insurance -- for anyone who went to Singapore for the $10,000 procedure, and would pay up to $10,000 for a traveling companion.

"Our intent was not to send a single patient," he said. "Our intent was to change the dialogue."

Sure enough, the dialogue changed as the offer garnered media attention. A hospital in Kansas called first, offering to do all the company's "hearts and hips" for $10,000. Then, a hospital chain made a similar offer. Finally, local hospitals in Maine and the Boston area agreed to talk, too, and the prices went from $50,000 to $18,000.

The company also told the hospitals they would need to meet the same standards as Singapore on the disclosure of information about infections and hospital re-admissions.

"And all that data we couldn't get before, they gladly brought to the table," he said.