Why CFOs Must Disrupt the Status Quo of Their Healthcare Benefits Plan

Why CFOs Must Disrupt the Status Quo of Their Healthcare Benefits Plan

CFOs find themselves face to face with the perfect storm — high inflation, increased demand for services and a prolonged spike in healthcare utilization. These factors are creating an escalating burden on companies of all sizes and wreaking havoc on their profits and losses. Health insurance costs are climbing at the steepest rate in years, reports The Wall Street Journal. Insurance carriers and the brokers who sell health plans to employers are incentivized to drive costs up, not down, yet CHROs still rely on representatives of those organizations to disrupt the purchasing process and contain costs. For this reason, it’s critical that CFOs and private equity firms play a much more involved role in developing their effective cost-containment strategies, that balance employee health with innovative ways to attack trend creep.

Management consultant Aon predicts that healthcare costs will continue their upward trajectory, a projection supported by estimates of over $15,000 per employee in 2024 and representing an 8.5% increase from 2023. That’s nearly twice the 4.5% increase that employers saw from 2022 to 2023. And because healthcare costs significantly erode EBITDA, 69% of Mercer surveyed CFOs identified healthcare costs as a substantial concern for their organizations.

With forecasts like this on the horizon, CFOs must shake up the status quo in their health benefits programs by inserting themselves in the details of their healthcare plans, working more closely with HR leaders to better understand benefits programs’ costs, utilization and ROI.

2024: Year of the CFO

As healthcare inflation increased over the last year and one-half, health premiums and benefits costs stayed essentially stable. In some cases, employer health plan contracts were in place, so cost effects were minimal. But now, with the post-pandemic increase in medical utilization, spiking hospital labor costs, growth in chronic and costly clinical conditions like heart disease, diabetes, mental health, substance use, and the surge in prescription drug prices, higher costs are becoming real, and phased in over years.

Businesses (along with their owners and shareholders) need CFOs to “take the reins” and bring their unique perspectives to the benefit strategy decision process in a much more assertive way. Minor tweaks to plan design or benefit offerings may no longer have the impact on cost reduction that companies now need.

CFOs must partner with their CHRO to ask the tough questions, like:

  • What employee utilization metrics do we get from our current healthcare plans?
  • What is our return from this utilization and the per-employee cost?
  • What are the hidden fees and commissions buried inside broker contracts?
  • Do we have the right plan partners, or should we unbundle them?
  • Can we improve the healthcare offerings to our workforce – while reducing cost growth at the same time?

The collaboration between the CFO and CHRO should attempt to challenge existing approaches, and even push consultants/brokers and carrier partners to do more to help their organizations identify alternative strategies.

With increasing focus on the CFO and their role as the company’s financial “captain,” we must ask how they are steering the organization: “How are you leveraging your healthcare plans to deliver the EBITA you need now? And what will you do in the next year to manage through the increasing healthcare costs while retaining a health benefits program that’s member-utilized, effective, and delivers a strong ROI?” ?

Answers to these questions are more critical now than ever. CFOs will want to bring focus, energy, strategy and innovation to healthcare benefits management now.?


By Todd Grove , Vice President of Private Equity at Quantum Health

Todd serves as the liaison between Private Equity firms, their portfolio companies, and Quantum Health. He works to educate senior leadership teams on independent navigation and identifies opportunities for partnership and collaboration. Todd drives EBITDA growth through support of unbundled plan strategies.

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