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All Companies With Self-Insured Plans Are in the Business of Healthcare

The challenges facing the modern-day benefits environment using out-of-date department design is the topic of a compelling podcast from Relentless Health Value™ by healthcare mavericks, Stacey Richter and Lauren Vela. Although it’s 30 minutes long, it’s critical to listen to and truly understand.


Here are a few of the highlights:

• All companies with self-insured plans are in the business of healthcare. Yet, no one seems to understand or acknowledge this. Many say that benefits departments are insufficiently staffed or have employees who lack the skills to manage a small insurance company. Other companies have outsourced key functions to consulting firms with incentives that are aligned elsewhere.

• Getting support from the C-Suite requires leadership with courage to challenge the status quo. Boards of Directors are asking about controlling the cost, yet this doesn’t seem to be getting through. I know from experience that it’s not just the EBCs who are vested in the status quo. A major business consulting firm told me that my plans to reduce cost and insource the work wouldn’t work. Without approval from the consulting firm, I couldn’t get a sign off from the CFO.


Fear is pervasive. There are HR leaders who are worried about finding out that their departments are not being run correctly even when they don’t have the staff or technology to do the kind of work Richter and Vela are advocating for.


• Changing the conversation from a focus on cost to how much revenue is needed to cover the benefits spend is more effective when seeking CEO and CFO approval.


• What does the new benefits leader look like? Today’s successful benefits leader has the skills and knowledge to be credible with the C-Suite and most importantly, the courage to do things differently.


• Containing healthcare costs can be an effective way to improve attraction and retention of employees. This is especially true for employees at the lower end of the wage scale who may be living paycheck to paycheck.


The Consolidated Appropriations Act of 2021 will finally provide clarity around EBC allegiance. Look for headlines as the commissions and fees come out at year end. CHROs and benefits leads will need to decide whether they make the call to the CEO or the CEO calls them. I say it’s better to be proactive!

4C Digital Health can help employers get to a level of insight into their healthcare claims that will put them on the same playing field as the Carriers. Companies that have this level of insight into their healthcare claims are better equipped to manage their costs and improve the quality of care for their employees. By analyzing claims data, companies can identify areas where they can reduce costs, improve quality of care, and identify patterns of underuse or overuse of services. Manage your company’s healthcare spend like you would any other part of the business.


Reach out to us today to get in control.


Written by:

George A. Murphy

EVP Commercial Marketplace

4C Digital Health

 

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