If you’ve read my blogs, articles, emails, and even my book, you know that I’ve ‘been around the block numerous times’ as a traditional broker for 35 years. In 2015, I couldn’t take it anymore and started my own consulting company. It was the way insurance agencies and brokers operate. Brokers and consultants put their clients on the hamster wheel doing the same old traditional actions every few years – change insurance companies to presumably lower costs, or recommend cost shifting to employees. It’s the Definition of Insanity.
It’s difficult for me not to share information that I know and what I’ve learned – knowledge, contacts, ideas, my expertise, etc. so at the end of the day your plan – and my clients plans – perform better. They are both affordable and sustainable.
It’s now about disruption. The only way that you and your company are going to make your health plan affordable to employees and financially sustainable for your company is to disrupt the status quo. It’s about thinking and looking outside the box for alternatives to BUCA (Blue Cross, United, Cigna, Aetna) and other insurance companies.
Think about this: who on your healthcare team has a financial incentive for your cost to go down? Well, let’s identify the team:
- Your broker consultant
- Your insurance company or administrator
- Big Pharma
- Your stop loss carrier
- Hospitals
- Doctors
At the end of the day no one on your team has an incentive for your cost to go down. In fact, they all benefit when your costs go up.
Researching nontraditional methods of lowering costs means disrupting the team – their interests are not aligned with yours. Next, it means searching and researching cutting-edge and innovative programs. These ideas are not going come from your existing broker/consultant – otherwise you would already have made changes. I’m not talking about moving to s self-funded plan, a different PPO network and insurance company, or a new PBM. Fundamentally I’m talking about changing the way all providers are paid, (including pharmacy benefit managers, brokers, stop loss, specialty drugs, etc.)
Disruption comes from a vastly new approach of providing healthcare and subsequent health insurance to your employees. You have to disrupt how these providers are paid, how you approach your prescription drug program with your PBM, how you eliminate PPO networks and the insurance companies, and the transparency with which you pay your broker. Let’s start with those. There is going to be a learning curve, some resistance from those who are comfortable with the status quo, and a few speed bumps along the way – because it is different than what we’ve all been conditioned to over the past few decades. Change requires disruption. Be bold and do what other successful businesses have been doing with their health plans.
The status quo isn’t working any longer. Get ahead of it and begin to crack some eggs and make that omelet. If you don’t know where to find the eggs and begin – email me at [email protected] or call me at 970-349-7707.
