Speak up: Benefits pros' public role when speaking about health care
Our readers share what type of approaches and strategies are making a difference when it comes to when it comes to speaking out about problems in health care and benefits, as well as the challenges of this public approach.
This really works
Direct primary care has completely changed the market value proposition for out-of-the-box advisors. Not only is the DPC delivery model aligned entirely with the patient and their wellbeing, but it has proven to mitigate the risk of more serious illnesses and larger catastrophic claims.
For those of us in the reference-based pricing world, the biggest administrative benefit is that DPC has organically reduced the noise and friction that comes along with alternative payment models like RBP. Referrals that happen doctor-to-doctor are not questioned and thus, we see far fewer access issues and a reduction in balance bills post-service. There is a clinical community out there just on the other side of our benefits financing fence who are fighting their own battle to put direct health care delivery back into the forefront and thankfully, the benefits and clinical world are finally colliding in the most effective collaboration we’ve seen under health care reform efforts in years.
The challenge in this is convincing people that there actually is something that works. In fact, DPC is just one of many effective strategies to take back some control in health care; and in particular, when you speak out about what doesn’t work, you need to expect the arrows to come flying because it threatens the comfort of a lot of long-time career brokers. Change is scary.
Emma Fox, partner/chief operating officer, E Powered Benefits
Sorry not sorry
I’m “guilty” of this myself. I put guilty in quotation marks, because I don’t actually feel any guilt for sharing my opinion in public forums—largely because I always do my research and present evidence whenever I make a claim. However, this is a great example of one of the pitfalls of this phenomena, because there are a lot of folks who are simply looking for forums to share their opinion without backing it with any credible sources, and we know how dangerous that is. But I believe this phenomenon yields a net positive, because it enables and empowers experienced subject matter experts to share the unpopular thoughts and ideas that can make the greatest impact.
Mike Rawaan, founder & principal consultant, Covalence Healthcare Consulting
Less blame, more collaboration
COVID vaccines, facemasks, racial equality, LBGTQ+ rights, gun safety, immigration, women’s reproductive rights, gender equality, the high cost of health care. What do they all have in common? They’re sensitive and often controversial topics, and almost all of them come up in the context of health care in one way or another. A growing number of benefits professionals are taking a more public role and speaking out, but not just on these issues. Whatever position one takes on an issue, pro or con or somewhere in between, it’s important to support everyone’s freedom and ability to publicly express thoughts and ideas, without all this “canceling” and backlash. Some may think “canceling” or publicly “outing” is the way to change an industry or a single organization, but I don’t believe it is. I believe our industry, and country for that matter, needs less finger pointing and more problem solving and collaborating.
As for challenges and roadblocks? The fear of retribution is real, and it prevents lots of ideas, thoughts and opinions from coming forward into the public space. The fear of getting a carrier appointment cut. The fear of being “outed” on social media. The fear of being embarrassed or criticized. The fear of being black-balled in a community and it hurting your business. These are some of the challenges and roadblocks to speaking out and taking a more public approach. So, I completely understand people’s hesitancy to adopt a more public stance, especially if it’s even remotely controversial, or goes against conventional wisdom. To overcome these fears, I believe that’s where the five attributes that comprise true influence come in: be competent, establish real credibility, have confidence, be compassionate, have charisma, and just be consistent.
Josh Butler, president, Butler Benefits
Matters of perspective
Prior to jumping into employee benefits, I worked as a firefighter/paramedic turned registered nurse. I have been fortunate (and sometimes unfortunate) to see many aspects of the American health care system. While I am proud of a lot of the work I have been a part of, far too often, I was frustrated with our system.
A growing number of benefits professionals and advisors are taking a more public approach for many reasons:
First, the squeaky wheel gets the grease. Second, I believe there is a generational shift in those advising and consulting. As newer faces come into this industry, or more experienced people get tired of the status quo, everyone is becoming more comfortable speaking up. Third, it’s impossible to list all the issues and changes that happened over the last few years, but I truly believe that this will be the catalyst to make some resounding positive changes. I also think people are increasingly comfortable speaking in front of a camera, which has opened the door for more people to speak up via social media platforms. Fourth, the snowball effect; I feel a lot of momentum building. Physicians, nurses, ex-hospital administrators, and current and former advisors are all chiming in. The momentum continues to build, and the snowball keeps growing.
There is the reality of “getting in trouble” with the large insurance carriers and hospital systems. There is a real fear for some advisors when it comes to challenging large carriers because they can be cut off. Sometimes large carriers make sense, sometimes they don’t. These advisors are trying to do what is right for their companies, not line their pockets with the highest commission they can squeeze out. To not have the option to offer a large carrier’s lines of coverage can be a real fear.
The same fear applies when challenging large local hospital systems. While transparency laws are coming into effect and continue to evolve and help, challenging prices and administration of local hospitals can put any advisor in a difficult position.
Eric Ross, chief strategy officer, Two Twelve Benefits
Speak up … the right way
Although I am outspoken, I am usually speaking out against “one-size-fits-all” solutions and cautioning against judging those who are not ready to take that path yet. Smaller employers in many states do not have the same options available to them that larger employers do. And often, even if options are available, they still may not be the right fit.
In my opinion, these discussions should always be conducted with kindness and an open mind about where the employer is now and what their comfort level is with change. For example, there is a lot of “BUCAH bashing” in our industry, which I disagree with. A group of seven with two high claimants is generally best suited to be in one of these fully insured, community-rated plans.
Does this mean that we can’t continue the discussion about transparency and educating members about costs and their part in this solution? Of course not. But a good consultant listens first, educates second, and then guides the client along the path.
Nancy Giacolone, president/owner, Olympic Crest Insurance
Keep in touch
I enjoy both one-on-one communications and public speaking when it comes to health care matters. I find communicating with my friends and colleagues in the industry is a great way to help me address and discuss ongoing challenges within our respective businesses. This is where the importance of networking and attending professional association and industry functions truly matters. There are many great innovators who are resourceful and well connected. Staying in touch with them allows me to track the developing trends in our ever-changing landscape. I also enjoy sharing content that will be impactful with my LinkedIn colleagues and friends and enjoy their thoughtful posts. As part of my professional development, I enjoy teaching CE classes and giving presentations on the matters which impact our colleagues today. Both NABIP (formerly NAHU) and HAFA are excellent legislative resources providing us with a voice and making a difference with our state and federal legislators. We all have a voice and platform to speak our minds and hearts. We all want to be heard and I want to hear you.
Wayne Sakamoto, president, Health Insurance Interactive, Inc.
Stay curious
Social media has created a much wider pipeline for new ideas in health care to be read, considered, and sometimes implemented. Thought leaders like Dave Chase, Chris Deacon, Marshall Allen, and Marty Makary have seen their perspectives turn into legislation, policies and plan designs. This is very positive for those who pay for and interact with the health care system. The best ideas don’t always come from legislators, health care executives or lobbyists. The paying public has been exposed to these thinkers and their concepts and responded accordingly.
But all of us have a difficult task sorting impactful information from the erroneous and irrelevant. Nobody can meaningfully sort through everything they get about “improving” health care.
I recommend looking for ideas with strong data from an independent source. And always consider the source. Seek out those who are knowledgeable, have well-thought-out ideas, go against the grain or conventional wisdom, and don’t have obvious conflicts of interest. View pieces written by coalitions and other entities that are lobbying fronts with a grain of salt. We must create our own filters to determine what to focus on and what to put aside. But let’s keep our curiosity; that leads to the best ideas.
Jeff Leston, president and founder, Castlestone
Take your time
One of the biggest strategies that I am vocal about is helping small to mid-sized employers consider self-funding their medical plan rather than remaining fully insured. With the right protections in place, employers with 50 or more enrolled on their health plan can be self-funded. This means better data, more transparency and the ability to create a strategy that actually responds to cost drivers, as opposed to accepting insured renewals that may or may not be justified.
The biggest challenge is that it takes time to educate employers about self-funding and some brokers tell employers that you must be larger to be self-funded, so we have to help employers understand why that may not be the case.
Cara A. Kirsch, area vice president, GBS
Trust me
A public persona is an important ingredient of trust—or lack thereof. Trust leads to followers and then customers. The “know, like, trust” principle is real in both friendships and business. Harvard Business Review had a nice article in 2020 about trust: “trust has three core drivers: authenticity, logic, and empathy. People tend to trust you when they believe they are interacting with the real you (authenticity), when they have faith in your judgment and competence (logic), and when they feel that you care about them (empathy).”
A public persona is a great way to build trust or hurt it. Ultimately, I’ve found that a more public persona gives you a better chance to find partners and clients that are aligned with your values. That is important to me.
Aaron B. Witwer, president, BenEngage
Get real
When highlighting problems in the health care industry, focus on specific, real-world examples from your clients, employees and families. While data is vital to understanding the big picture, people relate to and remember the stories behind the statistics.
For instance, if you are attending an HR conference in Memphis for the automotive industry, identify the specific challenges and cost drivers for HR leaders in that region and sector, then share how your client overcame those issues. Explain how an HR leader in the automotive manufacturing industry researched affordable mental health care options that employees can access on their mobile devices, thus expanding access to affordable health care. It’s easier for your audience to remember the anecdotes and solutions that reflect their employee base. Ask yourself if you truly care about the issues you champion. Modern communication channels, especially social media, can readily expose inconsistencies or lack of authenticity when speaking up.
Dinesh Sheth, founder and CEO, Green Circle Life
Related: Benefits pros come together to move the industry forward
Balancing act
There is a fine balance between thought leadership and a scorched earth mentality. From my perspective, do I feel that there needs to be change in the current health care system? Absolutely. This evolution has been a long time coming; however, I also believe that no single player is nefarious. We have a very poorly constructed system that has been built to extract dollars, without providing much value in return. For my firm and I, we seek to partner with those involved in the system, but hold them accountable for actions, as well as push the need for further transparency and compliance with laws that are meant to protect plan fiduciaries as well as their members. I believe the senseless and public shaming of entities is a short-sighted approach. Does it create a reaction? Yes; however, I would rather take the longer road by battle testing our philosophical viewpoints and seeking common ground for the betterment of all. Should we not reach that common ground, then you have what has occurred in Connecticut with a labor fund client of ours who has now been left with no choice but to file a class action lawsuit with a carrier that refuses to disclose data that they have a right to. The best path, in my opinion, is by all means to be passionate about your purpose, but also be intentional with the work you are doing to actually fix these issues. “Lip service” doesn’t equate to meaningful change, and we must be cognizant of that and ensure that our actions match our words.
Justin Leader, president & founding partner, BenefitsDNA