How One Of America's Most Innovative Benefits Leaders Reduces Clients' Healthcare Spending 20%

How One Of America's Most Innovative Benefits Leaders Reduces Clients' Healthcare Spending 20%

David Contorno is a great example of the folks highlighted in The Job That Could Save (or Crush) the American Dream. I believe benefits consultants are the single most underestimated role in the entire healthcare system. At their best, great consultants are worth their weight in gold and are underpaid -- after all, no consultant that I know of can contribute to both a high performance workforce (see Chapter 9 of my book) and create a major earnings increase that would be almost impossible to replicate via increased sales. At their worst (sadly, the mainstream), perhaps no other role has done more to crush the American Dream. Fortunately, the old guard is going the way of the dodo bid and being replaced by a new species of benefits consultant.

I thought I'd share the mindset of the leaders, such as David Contorno, as it is instructive for everyone. The following is from a LinkedIn post (click for a lively exchange) Contorno posted a couple days ago:

I get asked a lot how we lower costs as much as we do on an employer’s healthcare spend (like the 20% reduction, after already being below their fully insured costs of 4 years ago that Tara Derbick Conger, PHR, SHRM-CP, CPCHC is helping achieve at Palmer Johnson Power Systems.) The answer is simple.....if you want results opposite of what you have been getting, trying taking steps opposite of what people are doing currently. When the industry goes to higher deductibles, we remove them. When the industry goes to narrow networks, we remove networks. When the industry goes to narrow formularies, we expand them. When the industry invests in specialty care and surgical centers, we invest in primary care. When the industry looks to bring in more insurance products, we bring in less. Instead of increasing obstacles to getting any and all care, we need to be removing all obstacles to getting the right care. What is your opposite? What are you doing to #breakthestatusquo?

While the pain is palpable when pondering over the WSJ/Brookings graphic below, it's gratifying that in the short time since we launched the Health Rosetta benefits consultant certification, we already have consultants such as David Contorno representing 2% of the entire workforce. At first, that can sound small but consider this is over 2 million people who are on the path to receiving Quadruple Aim achieving care which is great for them, their families and the clinicians in the new care models. In the early days, exponential growth is easy to ignore until its momentum is unstoppable. It's our theory of change in action.

As alluded to in the dodo bird article referenced above, the smart stock brokers of 20+ years ago reinvented themselves as financial advisors with aligned incentives and proper disclosure of fees. They successfully grabbed huge market share from their laggard counterparts. Likewise, the vanguard benefits consultants are ensuring the plans they implement adhere to the Plan Sponsor Bill of Rights while the consultants themselves adhere to a professional Code of Conduct including proper Advisor Compensation Disclosure. Naturally, this is highly appealing to employers particularly in light of what a risk management practice leader at a Big Four consultancy called the largest undisclosed risk they've seen in their career (dereliction of ERISA fiduciary duty). Unfortunately, laggard benefit brokers/consultants are going to have clients be blindsided if they don't alert them to this rising risk.

Since we want to ensure that every health plan sponsor is aware of the risks and opportunities of having a modern health benefits plan, we're broadly/freely my new book -- the CEO's Guide to Restoring the American Dream: How to Deliver World Class Health Care to Your Employees at Half the Cost (click for a free download of the book). For the certified consultants, they are also broadly sharing the book so we've created special pages for them -- see Lake Norman Benefits' special book page as an example. Wise consultants are using these pages to partner with professional/trade associations in their region offering them a free book download. They not only provide the association with a valuable tool, this is a great tool to build the consultant's business. Once plan sponsors realize how much more they should expect from their health plan investment, it's a no-brainer to want to work with a forward-looking benefits consultant that is delivering high performance benefits plan. The woeful status quo becomes clear so they're eager to replace it.

Follow the link to the book below for a free download of the book that expands on the themes in this interview.

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Dave Chase is the co-founder of the Health Rosetta Institute (a LEED-like organization for healthcare), Managing Director of the Quad Aim Fund, Executive Producer of The Big Heist, and author of the book, “CEO's Guide to Restoring the American Dream - How to deliver world class healthcare to your employees at half the cost.” Chase's TEDx talk was entitled "Healthcare stole the American Dream -- here's how we take it back." The Health Rosetta Institute is transitioning from two years of self-funding/bootstrapping and recently achieved 501-c3 status. See the Health Rosetta Institute website for how to get involved, resources and how to join others to support its mission.

Subscribe to The Future Health Ecosystem Today to stay ahead of healthcare changes. Follow Dave on Twitter

Click for information on speaking engagements 

Davis Graham, MHMi

Teacher, Learning Resource Center and Advocate for Universal Design Learning with innovative technology

7 年

Dave Chase :I wanted to ask you why not use Medicare allowable as a base rate in your book and Rosetta health plan? We should start educating the public about the charge master by directing them back to the Medicare allowable and maybe later onto Medicaid allowable? Now that were starting to work on taking back our healthcare. We are also in the stage where we need to educate individuals in this country who have been so far separated from understanding healthcare that we need to show them there’s a baseline already embedded in the price of procedures which is the Medicare allowable (CPT code). For instance, in your book on page 57. You indicate that an MRI lumbar spine.contrast, the code 72148 ranges in price from $2600 down where in Florida zone 99 Medicare pays a global fee of $240.94 -https://www.dhirubhai.net/feed/update/urn:li:activity:6308027928403865600/ What are your thoughts on using the Medicare allowable as a way to teach individuals that there already is a price tag for each CPT code in healthcare?

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Davis Graham, MHMi

Teacher, Learning Resource Center and Advocate for Universal Design Learning with innovative technology

7 年

Your Book Dave Chase, points this DPC savings out on page 165. As you quote “Buckminster Fuller: You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” Let us make our two most archaic delivery and costly systems in America obsolete; healthcare and education!

Davis Graham, MHMi

Teacher, Learning Resource Center and Advocate for Universal Design Learning with innovative technology

7 年

In healthcare this does not happen we depend on others for healthcare. DPC model and Christian Healthcare Ministries is a great combination for those who feel led to purchase this type of coverage. The DPC can be brought in by a corporation and create a savings that is paramount and increases the quality of healthcare because now there is a patient/physician relationship. We in this country have to take back our healthcare we are at a place where we cannot afford not too. To do so we have to start right within our corporations it may take a little bit more time, just like it takes a little bit more time to go out of your way to make a savings on the gas fill up but it is worth it in the long run. Let’s keep this innovative model moving forward and an innovative model is any model other than the existing model.

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Davis Graham, MHMi

Teacher, Learning Resource Center and Advocate for Universal Design Learning with innovative technology

7 年

To reign in the cost of health is not easy but we all have some habit we do each day to save. One great example is how much does one of the strongest players CMS pay for a chest x-ray? Then ask how much is the price of a gallon of gas and when you fill up where do you go and why? Most people will answer the second question with no hesitation and state that they go to a particular station especially those who are on a budget for a savings of about $.60 a fill up. Savings come in small portions not big chunks, the avg. american will save $235, by doing so.

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Davis Graham, MHMi

Teacher, Learning Resource Center and Advocate for Universal Design Learning with innovative technology

7 年

David Chase:Thank you so much for the book. Employed sponsored insurance has distanced the patient so far away from a relationship with a physician that today nobody really knows about quality or cost.

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