By Bill Rusteberg
Recently I was referred to a large medical group that was interested in learning more about how we help plan sponsors manage their employee health care needs. They were fully-insured with a BUCA and tired of double-digit rate increases year after year.
They had learned a medical group we manage across town had “solved health care” utilizing out-of-the-box strategies with good success. They wanted to learn more about that.
I met with their CFO and his staff in a busy medical complex in San Antonio. The appointment was for 2:00 and it started at 2:00 as I was escorted into the conference room upon arriving minutes before. “I like this” I thought, “These people are punctual.”
They got right down to business, explaining the basis of their interest in meeting laying out precisely the issues pertinent to their situation followed by asking all the right questions. “This is great” I thought. “These people are on the ball!”
I shared some of our philosophies as applied to risk management and offered my views of various models in the market place with specifics. I quickly sensed they were well versed in many of these strategies so I pivoted to confirm that.
“You seem very well versed here. I sense I’m confirming much of what you already know. You’ve done your homework which is impressive and unusual. Tell me, how many brokers are you meeting with these days and how does this meeting stack up against all the others so far?” I asked.
A member of the CFO’s staff smiled and said “We operate under the belief that vendors don’t want us to know their business because it won’t be good for them, so we remove that barrier as best we can.”
How true that is, especially in the world of health insurance with all the closely guarded secrets industry insiders have been hiding from plan sponsors for years.
“You don’t want me to know your business because it won’t be good for you” is a telling statement because it underscores a deep, well deserved suspicion of the opaque world of health care finance in this country.
This meeting was really a great one. Never mind if I gain a client, that doesn’t matter.
I always welcome the opportunity speak to anyone willing to listen about the imploding health care delivery system in this country, walking them through the complicated maze of the American health care delivery system, exposing industry secrets that drive costs by outlining specific findings not generally known to Plan Sponsors. Offering common sense solutions to ever increasing health care costs always has a receptive ear.
I have found that armed with the knowledge industry insiders have kept hidden for years, Plan Sponsors are, for the first time, empowered to negotiate with insurance companies, managed care organizations and other third party intermediaries from a position of strength and can better achieve cost effective health care for their employees while often improving benefits at the same time.
It’s clients like this one we look to partner with in the continuing battle to slay the health care dragoon-monster known as the American health care system.
Business is about solving other people’s problems. Solving the high cost of healthcare giving employers a competitive advantage is ours. Status quo convergent thinking solves problems through a very narrow lens. Divergent thinking empowers us to solve problems with a wide lens allowing us to see what others don’t. You can’t fix what you don’t see. You don’t know what you don’t know. We see opportunities others miss. We do what others don’t. Winning together is our goal.
RiskManagers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods. The shared vision of RiskManagers.us and clients who retain our services is to establish and maintain a comprehensive employee health and welfare plan, identify cost areas that may be improved without cost shifting to any significant degree, and ensure a superior and sustained partnership with a claim administrator responsive to members needs on a level consistent with prudent business practices. Plan costs, in all areas including fixed expenses and claims are open for review on a continuing basis. Cost effective plan administration and equitable benefit payment to providers are paramount to fulfilling our mutual fiduciary duties. As we proactively monitor and manage an entire benefit program we are open to any suggestions members may make or the dynamic health benefit market may warrant in order to accomplish these goals. Duty of loyalty to our clients, transparency and accountability are essential to the foundation of our services. To that end, we expect our clients to realize a substantial savings based upon the services that we will deliver.
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