I’m the child of a long-time human resources leader. My mom ran human resources for small and mid-market companies for more than 30 years. I got to learn about HR and benefits by osmosis. Regardless of company size, she negotiated health care plans and always tried to self-fund them if company cash flow could support it.
After working on healthcare revenue cycle projects and products I realized that the system wasn’t designed for consumers, employers, or providers. Healthcare finance is broken and it’s even a barrier to improving population health.
The lightbulb went on after a conversation with my mom where she reminded me that most employer insurance is self-funded…
Providers want to take care of patients and get paid for their work. Consumers want to get great care and make good decisions about how they get it. Self-funded employers want employees to make informed decisions and for the same consumer pressure to be applied to healthcare finance (so they can pay less).
So let’s help Employers, Third Party Administrators, and brokers improve their claims and plans. Let’s use new technology and (compliant) data to do a great job of connecting them to and managing contracts with providers. THEN let’s create transparency and the ability for employees to make informed decisions about the quality and cost of their care.
Fixing health care in the United States is a difficult problem. We have to think differently about how to solve it and pay for it because legislators and traditional payers aren’t going to.