I don’t usually speak up about it, but with the debate going on right now in the U.S. about single-payer, I keep hearing that it doesn’t work, or that people don’t get care, get sick and die. And it’s simply not the case. As someone who grew up in the system, I can tell you that what happens in the NHS is prioritization. If I’m rushed to the hospital with appendicitis, I’m going to get my appendix removed immediately. Whereas if someone walks into the A&E with a sprained ankle, they’re probably not going to get immediate service. The people who receive the care fastest are those who need it most.

Related: How America’s broken health care system came to be

To me, that model makes perfect sense, but I don’t think it can be implemented here, and I think most of that is politically driven. It has a lot do with the misconceptions about how universal health care really works. There’s hesitancy to allow the government to have its hands in health care, and I also think people are set in their ways and just used to this system. But we can at least start by offering health care to everyone and fix the accessibility problem. I don’t think the health system over there is perfect, but it’s certainly not as narrow as many people here believe.

PW: What’s your perspective on the industry these days? What are the biggest opportunities and challenges you face?

The biggest challenge I’m facing is adversity in terms of opinion. Just today, I met with a consultant who has been in the industry for a long time, doing the same things that have proven tried and true. That’s difficult to overcome, because I actually track data and am able to see what does and doesn’t work in terms of cost-containment.

So many brokers are used to an older model that generates a certain percentage of premium and commission, and they’re really scared to break out from that. The problem is that you’re not able to provide much of a solution if you can’t do something different.

Most employers I talk to are intrigued by what’s available, and many times, it’s something they’ve never heard of before.

PW: What successes have you had in changing minds?

A client of mine has a really high-dollar claimant on their books right now and they’ve been dealing with it for a couple of years. They’re more of a traditionally self-funded client and they finally got to a point where they realized, “We have no choice but to try something different, because our company just can’t sustain this anymore.” It’s unfortunate that people get to that point when we could have addressed it a year ago. Again, the hesitancy comes from a place of fear: “What will my members think? What will their experience be?”

We’ve had many successes, though. We had one client we took from $11 million down to $4 million in claims in just 12 months. You just have to have a certain level of bravery and trust to step into it. But as long as you have good consultants who can really back up that data, you can establish quite a bit trust to get someone to follow and have a better outcome.

PW: It’s key to maintain quality while cutting costs. What strategies work?

Direct primary care is definitely part of that. We also work with a few different RBP vendors and the best ones have proprietary software that actually tracks the quality of facilities and physicians. They reach out and make direct contracts with local hospital systems providers and they ensure that members are receiving quality care. You can wrap RBP with care quality and have the entire package available.

PW: What reactions are you seeing from providers when it comes to RBP?

The biggest pushback is coming from the heavy-hitting hospital systems. The cost of services in bigger facilities tends to be higher, so they tend to be more adverse to writing off a larger delta between what was billed and what was actually paid.

You can start by asking a provider, “Do you take Medicare?” If the answer is yes, then it shouldn’t really matter who the patient is. If you usually take Medicare pricing and we’re offering to buffer it at 30 percent or 40 percent more, there shouldn’t be much pushback. The second thing is, you should have your percentage at a reasonable amount—you really want to be at 140 percent or 150 percent. Show them they’re still going to get paid fairly and without a lot of the headaches they face with the more traditional model.

PW: How will transparency in health care continue to play a role going forward?

One of the pioneers in transparency is Pearl Health Partners here in Portland. Dr. Richard Rosenfield runs the practice, and he’s created a network of gynecological surgeons. He’s been very outspoken about bundled services, quality of care, doing things laparoscopically and in an outpatient setting.

More providers are realizing that if they can be more efficient and get paid appropriately, they get better at their job, which increases their quality. They can make far more money in that model.

And brokers moving toward a more transparent fee model are having success, because if you’re tying your compensation to your ability to get results, not only does that put a whole lot of pressure on you to get results, but it also justifies the amount of money you get paid.

PW: What aspects of data and technology are you most excited about?

We track medical claims data and pharmacy and now have little indicators in our reports that tells us if a member has filled four different prescriptions with four different providers in a certain period of time. That’s generally our red flag for potential opioid abuse.

Pharmaceuticals are a big spend for health care, and if we can identify where some of the abuse is happening and can identify solutions for it, we’ll be able to make a big impact.

PW: How can the industry do a better job of attracting more women and diverse, innovative consultants?

It’s a matter of engagement. I am constantly looking for opportunities to learn from everyone I meet, whether they’ve been doing this for a year or 25 years. I probably learn more from folks who are stepping into the industry and have a different perspective on health care now than people who have been doing this for 30 years and may be stuck in a rut.

There are more women like Rhea Campbell and Rachel Miner who are willing to speak up, even knowing it does come with a small degree of criticism on the back end. Those of us who do speak up encourage the quieter women to do the same.

PW: What are your sources of inspiration and innovation?

I’ve found that if I have a frustrating day at work and need an escape, I can usually hash out most of it lifting weights at the gym. I also write quite a bit about my thoughts and feelings on the industry.

There are people I really look up to in the industry, like David Contorno, Kevin Trokey, Keith Wallace with Rice Insurance in Washington and Jolene Bryant who works at the Wilson Agency up in Alaska.

PW: What are your favorite things about your job?

It’s definitely not plan documents and contracts! I really like that every single client I come across is different. I have clients from 150 lives all the way up to 7,500 lives. They’re all self-funded, but that’s really the only thing they have in common. That requires so much puzzling and strategizing and that’s, by far, my favorite part of the job.

PW: Finish this sentence: The key to success in this industry going forward is…

Being open-minded, willing to learn and open to collaborating with your peers.

Read more from our Face of Change series:

• Change is constant: A Q&A with Naama O. Pozniak
• Always moving forward: A Q&A with Laura Frances
• Something has to change: A Q&A with Kassi O’Brien