America's Most Innovative Benefits Leaders: Keith Robertson

Healthcare's dysfunction and out-of-control costs are well documented. I've been on a quest over the last seven years to find the “health reform" that few talk about--the do-it-yourself kind. A set of benefits leaders have not only tamed the healthcare cost beast, they are showing that the best way to slash healthcare costs is to improve health benefits.

Underlying political unrest that is in the headlines is the fact that the middle class has gone backwards in the last 20 years is a direct byproduct of healthcare's hyperinflation. Consequently, it paints the picture that healthcare is the single greatest immediate threat to America. As I've spoken around the country, it's clear that company executives are boiling mad and want to revolutionize health benefits purchasing and realize they’ve been passive for far too long. They are demanding that their benefits brokers step up their game. It's great to share stories about benefits leaders who didn't simply throw up their hands about healthcare's under-performance--they were committed to restoring the American Dream that has been taken away from many.

The C-suite and benefits leaders I present to are champing at the bit for proven models of success. The leaders highlighted in this series are gaining a great market advantage while far too many of their counterparts are asleep at the wheel as highlighted in Benefits Brokers Are Dead. Long Live Benefits Advisors. The forward-looking advisors came to the realization that they are either part of the problem or part of the solution. I have yet to meet the benefits consultant who consciously wants to contribute to the continued decimation of the middle class by delivering under-performing benefits packages -- many are just waking up to that reality. The recurring theme to the fixes are that they don't advise removing old (under-performing) benefits as that would be too disruptive. Rather, they make the old "Tier 2" and make the Health Rosetta-based approach Tier 1. Put simply, they make bad decisions expensive for the employee and good decisions free or near-free allowing both the employee and employer to win.

[Disclosure: As I've disclosed many times, the Health Rosetta is a non-commercial open-source project that provides a reference model for how purchasers of healthcare should procure health services. In my role as managing partner of Healthfundr, a seed stage venture fund, the Health Rosetta is the foundation of our investment thesis.]

It's inspiring to see employers who have delivered superior health benefits while spending 50% less per capita. Or, how a small manufacturer solved healthcare's most vexing problem--pricing failure--and were influential in leading the largest nonprofit health system in the country to go truly transparent on pricing. It’s not limited to the private sector. School leaders on both the management and union side in Pittsburgh acted like adults and worked together to slay the healthcare cost beast. Unfortunately, most labor-management disputes are stuck in the tired old approach of fighting over health benefits when they should be fighting in common cause against a healthcare system rigged to decimate their budgets.

This series will highlight the most innovative benefits leaders who are ensuring healthcare realizes its full potential. They don't accept we have to leave a disaster behind for the next generation--the largest generation in history is increasingly saddled with a colossal mess by their boomer parents. Time and again, they show it's possible to break the cycle of employers spending more than enough money to fund great health benefits and a comfortable retirement yet getting neither with the status quo. In this series, I'll focus on benefits consultants, benefits executives and innovators delivering high-performing benefits. Some will come from the large benefits consulting firms such as such as Aon Hewitt, Mercer and Towers Watson but many are off the beaten path doing great work.

Fortunately, there are employers, school districts, unions and many others who are receptive to the open source Health Rosetta blueprint. I’m regularly asked to speak about how to thwart the heist at customer events for TPAs and benefits consultants, business coalitions, non-profit associations, and public sector organizations. The overriding sentiment is the C-suite and benefits leaders have reached their breaking point and are no longer going to accept that every year they’re obligated to get less and pay more when it comes to health benefits. Consequently, benefits consultants are increasingly following the lead of Keith Robertson and David Contorno who I highlighted previously.

Keith Robertson, V.P./ Corporate Benefits Consultant at Alliant Insurance Services

Robertson is a benefits consultant that I highlighted in an earlier piece that demonstrated that the best way to slash healthcare costs is to improve health benefits. He accepted the challenge from a visionary HR leader, Jim Lopez of Kirkland, Washington.  Robertson is a strong contrast with benefits brokers who are acting like stock brokers who’ve gone the way of the buggy whip. He recognizes that the middle class has been decimated by a passive benefits approach that accepts that it’s “normal” to have year after year of double-digit premium increases -- nothing could be more absurd. I asked Robertson to expand on his approach and how he’s incorporating Health Rosetta thinking into his client portfolio.

What is your philosophy for how you approach benefits, and what kinds of results have you seen?

“We could if…” is the most empowering phrase I know.  Most people I meet live in a “We can’t because…" world, and guess what?  They see themselves as always facing insurmountable obstacles.  Their lives are characterized by frustration and victimhood, unable to see possibilities.   “We could if….” People, on the other hand, live in a world of opportunity and creativity.  The American healthcare system is clearly dysfunctional, overpriced, and under-performing.  There is no shortage of reasons for pessimism.  So, I approach every challenge, every renewal, every frustrated business owner from the same starting point: (a) What is the problem? and (b) what is the desired outcome?  Then I complete the “We could if…” sentence.  I am continually amazed at how quickly this little mental exercise changes my mood, my outlook, creates hope, and sparks ideas.

Two years ago one of my clients (Jim Lopez, City of Kirkland WA), saddled with an unsustainable average 10.8% year over year trend, told me I had to flatten their costs for the next 10 years. Further, I could not shift any costs to the employees or degrade the plan design.  At first it seemed to be an unreasonable request until I began working my “We could if…”  mantra.  Fortunately this client was also a believer in possibilities.  We began meeting every Wednesday morning to figure out how to defy the odds.  We figured out a strategy that resulted in a -5.5% renewal, reduced the employee out of pocket costs by 20%, and increased the amount of primary and preventive care delivered by 37%.   The answer to my favorite question was:

• “We could if…”  We could provide unlimited primary and preventive care, FREE to the members.
• “We could if…”  WE were to drastically improve the experience of consuming healthcare.
• “We could if…”  That care was provided at cost, no margins or mark-up.
• “We could if…”  We could if every procedure referral was agnostic, and cost-outcome efficient.
• “We could if…”  The employees benefited personally and financially by “buying in” to our new program

What was the new program?  It was a full systems approach centered around a state of the art employer sponsored clinic, an account based High Deductible plan, and a high touch concierge referral support system providing real time procedure pricing and live scheduling assistance for all referrals.    It sounds exotic, but we proved that More is Less when it comes to healthcare. Unrestricted no cost primary care reduces admits, days per admits raises ones medical IQ, and empowers expensive complex chronics to self-manage.

I can hear someone saying “We could never do that because we are too small, our unions would never agree,  and our employees would never change doctors.  We did it with only 325 employees.  Five of their six unions voted overwhelmingly in favor, and the clinic has had to expand its hours due to demand exceeding our expectations.

How you plan to or expect to incorporate the Health Rosetta?

Health Rosetta provides a place where innovators can share ideas and connect with vendors that “get it” and can deliver the services  that can take innovation from the whiteboard to the playing field where ideas become programs, and programs become solutions.

Here's what a client (Jim Lopez, Director of Human Resources and Performance Management for the City of Kirkland, Washington) had to say about Robertson:

“Keith is at the top of his game when faced with a challenge. I remember when we told him the City of Kirkland was rethinking our entire approach to delivering health benefits. Rather than shrink from such a challenge, Keith got energy from it. He brought us the latest thinking from around the country and provided great insight into several cutting edge approaches to delivering care. Together we evaluated each strategy and ultimately designed our “full systems” model of care. Keith’s contribution to the process was absolutely essential.”

This article was also published in Forbes

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