Why a high performing health plan is like a Prius—and that's a good thing
Even though the net promoter score of the major insurers is in the single digits, many American employers are too afraid to design a plan that isn’t run by one of them. Until now.
Well, it finally happened. I recently became the proud owner of a cute, pearl white Prius and I couldn’t be happier. There were nine miles on it when I drove it off the lot and two days later, there were 400 miles on the odometer. Funny thing is, half of the “free” tank of gas the dealership put in still remains. I’m in love.
I know what you’re thinking. “But you’re supposed to be a successful benefits broker. Can’t you afford anything better than a Prius?” Trust me, with the abuse I put my work car through, I can’t be trusted with a car worth any more than this. It’s just not a good idea. After all, I’m not my buddy David Contorno, with his big, fancy car and his personal driver.
Yesterday, as I was driving, I began to pay close attention to the monitors and displays that light up with every touch of the gas pedal. It shows me when the battery is providing all the power, when the power is coming from a mix of battery and gas and when the car is using 100 percent gas. This really got my “wheels turning” (pardon the pun).
I was reminded of how a transparent, high-performing health plan works and how a successfully run plan only spends about half as much as a traditionally funded plan with no view into the actual unit cost of healthcare. I’ve told clients and prospects that the technology operating behind a transparent, high-performing plan allows the plan to save money even when you’re using the high-cost sites of care like hospitals and facilities. On the other end of the spectrum, you completely level your exposure to claims costs (why don’t we call this renewable energy?) by embedding direct primary care into your plan design. That’s just like when your Prius is only using the battery to get you from point A to point B. Everything in between is a mix of great technology and a smarter use of your plan’s resources. Just like the gas in your car.
Why is this so important? Well, the Kaiser Family Foundation just reported that American families and employers are spending around 67 percent more on health care than they were 10 years ago. Health care has exponentially outpaced inflation and it’s killing our economy, causing wage stagnation and keeping American workers from being able to retire on time.
Why do we tolerate this? Because big insurers are marketing geniuses. And we bought it hook, line and sinker. Even though the net promoter score of the major insurers is in the single digits, many American employers are too afraid to design a plan that isn’t run by one of them. Until now.
At a very grassroots level, employers of all sizes and make ups are seeing the direct primary care practices build a presence in their communities. Many seek out that care and then decide they want to try it out for themselves. They’re instantly hooked. They want to provide it as an option to the rest of their workforce. They ask their current broker to help them implement it and that’s where the difficulties start. They hear things like, “this is just an added expense” or “your employees already have all of the doctors in the network” or “this won’t work with your health savings account.”
That’s music to my ears. My most recent client acquisition told me just before I was hired that it was refreshing to hear someone say “yes, you can” when cost containment solutions like DPC, transparent pharmacy benefits and bundled surgical agreements were inserted into the conversation. They told me all they heard from their incumbent broker was how the status quo was the best they could do.
But not all employers are so bold. Many are too afraid that their employees will revolt at the mere mention of a different insurer. Well, I’ll just describe the open enrollment meeting I had with this new client. The changes were explained, the booklets were passed out, heads nodded, frowns turned to smiles and several employees were giving high fives to the CFO as they walked out of the conference room. I’d say those employees were pretty happy with the changes. Here’s the difference. Instead of employees being given bad news, they were told the following: “Your primary care visits are free.” And “your generic prescriptions can likely be dispensed right in your DPC provider’s office. No need for a separate trip to the pharmacy.” And “if you follow the nurse advocate’s recommendation of the high-quality provider for your procedure, it’ll be no cost to you.”
I’m no genius, but that sounds a whole lot better than “copays, deductibles, co-insurance and premiums are going up again.”
What’s my point? Employers have options. More importantly, so do employees. Someday employers may have to come to the sad reality that an outdated benefits package just cost them the great new hire they were recruiting. When that day comes, they’ll know where to reach me. I’ll show up in my cute, pearl white Toyota Prius that got me there at a rate of about 60 miles per gallon.