Three Ways CEOs Can Fix Company Healthcare Plans


CEO of Orriant. Helping CEOs lower costs and increase productivity by aligning healthcare to work for them instead of against them.

Imagine if the healthcare system focused on the needs of the individual rather than financial gain. There would be far fewer clinic visits and hospitalizations if the system invested more in assisting individuals in taking control of their health and living healthier lives. This approach, supporting each individual’s health aspirations versus fixing problems when they arise, has been proven to be far more effective, both improving health and costing less.

CEOs can fix company healthcare plans through three simple strategies: alignment, choice and relationship.

Alignment: Most CEOs fumble their fiduciary responsibilities by allowing enormous perverse incentives to exist throughout the healthcare system. By instead defining their business objectives for buying healthcare and then aligning all parties involved to support those objectives, CEOs could get what they want.

Simply align your internal team as well as your external consultants to work for you. Reward them when they help you meet your business objectives. This requires implementing monitors to measure how well you are reaching your objectives. Companies almost always ask their external customers how well they are meeting their needs. However, they seldom ask their internal employee-customers how well the health benefits meet their needs. Often this is because they already know that the healthcare system is dysfunctional, impersonal and expensive, and they don’t want to hear this from their employees when they don’t know how to fix it.

Choice: New federal regulations allow CEOs to offer employees choice like never before. Historically, employers had to purchase an insurance plan for their employees to get the tax deductions. The new Individual Coverage Health Reimbursement Account (ICHRA) allows employers to offer a flat amount or a defined contribution, which employees can use to purchase whatever insurance plan best meets their family’s needs. If it costs less, the difference can be used to reimburse qualified medical expenses. If it costs more, employees can pay the difference through payroll deductions.

When employees are given choices, a world of alternative options opens up. Given the option and education, many employees may choose to participate in alternatives to insurance, such as health sharing programs. Many, but not all, are faith-based, which may be a consideration for some employees. But they cost far less than insurance and in many cases reduce the employee’s out-of-pocket risks significantly, an important factor when medical bills account for 66% of bankruptcies in the United States.

Even more importantly, with choice, CEOs can stop putting all their eggs in one basket and create an aspirational model of healthcare for their employees. Instead of just giving employees money to purchase a medical plan, CEOs can distribute funds into three other areas: to pay for a family doctor, to incent employees to work with a health coach and to put in a medical cash account for qualified medical expenses.

Family Doctor: Primary care is badly broken in this country and most practices have been purchased by healthcare systems that make more money the more services they deliver. CEOs can allocate funds specifically for Direct Primary Care (DPC) or Virtual Primary Care (VPC). These are subscription models of primary care where physicians receive a monthly retainer from each of their patients/members rather than billing insurance. Their incentives are aligned to keep their members healthy, and they can act as an independent medical partner to coordinate all healthcare when additional care is needed.

Coach Incentive: The foundation of successful models of aspirational healthcare is always self-care. Helping individuals take ownership of their health and live life to its fullest is fundamental to better outcomes and lower costs. When funds are allocated specifically for incentives that members can earn by working with a coach, most employees will take advantage of this proactive approach to healthcare. A third-party accountability partner can play a tremendous role in helping people win the battles within and get out of the unhealthy ruts that frustrate them the most. (Full disclosure: My company provides health coaching services, as do many others.)

Medical Cash: In addition to the new ICHRA, federal regulations created the Excepted Benefit Health Reimbursement Account (EBHRA). This new account offers employers enormous flexibility and provides employees tremendous choice. Employees who are offered an Affordable Care Act-qualified insurance plan can choose alternatives to traditional health insurance and still save money tax-free for future qualified medical expenses. EBHRA funds can also be used to reimburse employees for excepted benefits such as dental, vision, supplemental or short-term limited health insurance policies.

Relationship: Successful healthcare systems are built on the foundation of relationships. Imagine if every individual had a trusting relationship with three key partners who were available to support them in their health and help them navigate the healthcare system.

• Benefit Partner: This trusted partner guides patients through the complexities of health benefits and can help minimize financial risks.

• Medical Partner: This is the DPC or VPC doctor whom the patient gets to know personally and is available to help patients deal with medical emergencies as well as navigate complex or chronic medical conditions.

• Coach Partner: This is a trusted accountability partner who doesn’t tell the patient what to do but supports them in living life to its fullest.

CEOs can fix their corporate healthcare plan by aligning the system to work for them, by giving their employees choice — which can result in significant savings — and by offering relationship-based healthcare that creates much higher levels of customer satisfaction.


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