Where Payer Strategy Meets Execution With Benefitbay CEO Brandy Thompson

Summary

Becker’s Healthcare Podcast Summary

Episode: Where Payer Strategy Meets Execution With Benefitbay CEO Brandy Thompson
Release Date: February 22, 2026
Host: Scott King (Becker’s Healthcare)
Guest: Brandy Thompson, CEO & Co-Founder, Benefitbay

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Episode Overview

This episode centers on the evolving landscape of payer-provider relationships in healthcare, with a particular focus on the ways payer strategy often misaligns with operational execution. Brandy Thompson, CEO of Benefitbay, shares candid insights into the administrative and technological challenges facing health plans, explores opportunities for innovation, and discusses regulatory and market shifts shaping the future of healthcare benefits for employers and employees.

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Key Discussion Points & Insights

1. Brandy Thompson’s Background & Motivation

[01:02 – 01:56]

• Brandy climbed the ranks through operations and finance, with academic credentials in accounting and an MBA in finance.
• Her drive to innovate in healthcare comes from understanding both employer and employee perspectives—balancing affordable benefits with business needs.
• Benefitbay’s mission focuses on enabling employers and broker consultants to maximize defined contribution models and add consultative value.

2. Changing Provider Relationships Amid Cost & Workforce Pressures

[02:13 – 03:07]

• Significant market uptake of Individual Coverage Health Reimbursement Arrangements (ICHRAs) is shifting administrative burdens.
• Providers and payers are uniting over shared technology and cost pressures, investing in digital transformation to enhance the member experience.
• Both sides are more motivated to integrate systems directly to avoid escalating administrative costs.

  “There’s enough of just a momentum overwhelming across all aisles... Come on, we’re smart people, let’s solve these problems.” – Brandy Thompson [03:31]

3. Increased Collaboration Driven by Mutual Regulatory Pressure

[03:07 – 04:07]

• Broad regulatory and operational stress has fostered a sense of partnership, not rivalry, between payers and providers.
• Legacy technology and traditional processes have long perpetuated inefficiency—a reality now widely acknowledged.
• Administrative complexities (e.g., prior authorizations) are a common pain point, but the collective will to fix them is at a high.

4. Where Payer Strategy Fails to Meet Execution

[04:07 – 05:28]

• Health insurance carriers tend to plan ahead strategically, but execution lags, failing to keep pace with real-time market needs.
• Recruiting challenges and resource constraints slow operational agility.
• The industry’s entrenched processes make it “move like such slow cruise ships” and “constantly taking on ice and taking on water.”

  “To turn and move the iceberg is not something they can do...we’re constantly taking on ice and taking on water due to the speed at which these payers can move.” – Brandy Thompson [04:23]

5. Game-Changing Investments for Health Plans

[05:28 – 06:34]

• Streamlining compliance: Reducing outdated administrative habits, like reliance on faxes, in favor of more modern, efficient workflows.
• Attracting new talent: Bringing in motivated innovators will help reduce administrative costs and solve entrenched issues.
• Both steps are essential for plans to operate cost-effectively and respond to evolving regulatory environments.

6. Regulatory or Industry Changes to Enhance Affordability & Access

[06:34 – 07:27]

• Brandy spotlights the need to fix silver tier affordability regulations so affordability can be calculated on off-exchange products—speeding up quoting and improving employer and employee choice.

  “That would move speed to quote in this environment. It would also accelerate a pace for employers to be able to make decisions and make choice available to their employees...” – Brandy Thompson [06:54]

7. Pressures on Health Plan Margins & Responses in 2026

[07:27 – 09:59]

• Administrative bloat: Multiple intermediaries between patient and provider inflate costs and create failure points.
• Providers face excessive hurdles due to preauthorizations and multiple rules, preventing focus on care delivery.
• Brandy critiques blind optimism in AI, given high denial rates—prefers reducing administrative friction over new tech for routine care.
• Benefitbay’s direct connectivity to health plans minimizes costly intermediaries, eases reconciliation, and reduces the “food chain tax” (often 10–15% of healthcare spend has nothing to do with access to care).
• Improving margins will require breaking out of entrenched 30-year-old processes and focusing on accountability, directness, and operational efficiency.

  “When you insert multiple people into the food chain... you also have a cost for each one of those solutions. And so that drives up the cost.” – Brandy Thompson [09:05] “We need to get out of our own way in some of those routine care access challenges. I don’t think AI is the answer.” – Brandy Thompson [08:40]

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Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote/Insight | |-----------|---------------|--------------------------------------------------------------------------------------------------------| | 01:34 | Brandy | “Being in that operations and finance seat ... drives the passion for Benefitbay and what we do here.” | | 03:31 | Brandy | “There’s enough of just a momentum overwhelming across all aisles ... let’s solve these problems.” | | 04:23 | Brandy | “They move like such slow cruise ships... taking on ice and taking on water.” | | 06:54 | Brandy | “That would move speed to quote in this environment ... and drive consumer accountability.” | | 08:40 | Brandy | “I don’t think AI is the answer. We’ve seen a lot of incorrect denial rates ... that have caused risk.” | | 09:05 | Brandy | “When you insert multiple people into the food chain... you also have a cost for each one of those.” |

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Important Segments & Timestamps

• Brandy’s Background & Motivation – [01:02–01:56]
• Evolving Provider Relationships – [02:13–03:31]
• Industry-wide Motivation for Change – [03:31–04:07]
• Strategy vs. Execution Gaps – [04:07–05:28]
• Investments/Initiatives for Coming Years – [05:28–06:34]
• Regulatory Priorities for Affordability & Access – [06:34–07:27]
• Marginal Pressures and 2026 Actions – [07:27–09:59]

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Summary Takeaways

• Payer-provider dynamics are evolving to more direct, technologically connected relationships, driven by mutual cost and regulatory pressures.
• Legacy processes and slow-moving execution remain healthcare’s Achilles’ heel—modernization and talent infusion are urgently needed.
• Regulatory tweaks (like recalibrating affordability benchmarks) could rapidly improve speed, access, and consumer choice for employers and employees.
• Simplifying the administrative “food chain” and focusing on operational efficiency will reduce wasteful spend and improve plan margins.
• Collaboration, not competition, will drive true progress: “Thought sharing is how we’re going to solve this problem.” [10:09]

Transcript

[A]

This is where health insurance leadership comes together. Becker's 4th Annual Spring Payer Issues Roundtable brings together over 400 payer and health plan executives and more than 100 speakers to Chicago, April 13th and 14th. This year's event includes keynote conversations with the industry's top leaders and former President George W. Bush. For the full agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you here in Chicago.

[B]

Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm Scott King, thrilled today to be joined by a very special guest who's speaking with us at our Spring Payer Issues Roundtable, and that's Brandy Thompson, Chief Executive Officer of Benefit Bay. Brandi, how are you doing today? Thanks so much for joining us.

[C]

I'm doing great, Scott. Thanks for having me. Always a pleasure.

[B]

Of course. You know, we have a lot of big topics to dive into here with health plans and health care, but before we do that, I was wondering if you please just share a little bit about your background and your career journey.

[C]

Yeah, absolutely. I am the CEO and co founder at benefitbay, and my career journey was up through operations and finance. I've got an undergrad in accounting and a master's degree in business administration with a major in finance there as well. I was really motivated to solve health care challenges from being in that operations and finance seat, knowing that your people are, you know, tackling their work life, balance, their families, everything that they're tackling, but also tackling what the employer and the business needs to tackle from being able to afford benefits and then being able to control those outcomes. And so healthcare really meets at the intersection there. And that's what brings the passion for benefitbay and what we do here in trying to make an impact in defined contribution for employers and be the enabler for the broker consultant to provide that consultative value to their client.

[B]

Thanks, Brandy. I appreciate you giving that background info and sharing the mission there of Benefit Bay. And the first topic I wanted to get to is how are your relationships with providers changing, you know, as both sides face cost pressure and workforce shortages?

[C]

Yeah, I mean, that's been a real pivotal change for the payer side. I think there's two things that are crossing at this intersection, which is that there is wild adoption in the individual coverage healthcare reimbursement arrangements out there in the market. So they've got cost pressures to service individual policies for employer groups. And that side of the house may not have had as much technology investment in the past. So what we've seen is that the relationships are really growing with the providers because they are facing administrative cost pressures and they also have workforce shortages. So they have to invest in the technology outcomes to improve the member experience. We've seen a lot more motivation from the payer side to do that. And we've also seen the payers motivated to ensure that they're integrating direct so that they're not driving up the cost of that individual product or that plan administration.

[B]

Yeah, you know, it's been an interesting week. I've been speaking with some providers and some payers and it seems like just with regulatory pressures on both sides, people are just kind of both coming to the table and then on both sides and being like, you know, like, we're under this pressure. I know you're under that. And they're like, let's just try to get something done. Is that kind of what you're seeing too is, you know, maybe there is a little more compromise right now just because everybody's up against so much.

[C]

Yeah, I just think there's a motivation to solve the problem. I think there hadn't always been a willingness to face that the legacy technology was causing a problem, that the way we've always done health care was causing a problem, that all of the additional administrative barriers that were created and priors and various processes were causing provider and access to care challenges. And I think there's enough of just a momentum overwhelming across all aisles, across all pieces to say, we've got to be able to do this better. Come on, we're smart people, let's solve these problems.

[B]

Where do you see the biggest gap today between payer strategy and operational execution?

[C]

So I think in that same, I think in that same breath, I've seen a lot of momentum, I've seen a lot of excitement. But where the payer execution is still, especially in our industry, in our side of the aisle, is care carriers. They'll. They'll develop a strategy a couple of years ahead, and so the execution just isn't there where the market momentum is at the time. So there's still a lot of those pain points. So we know they have the investment, we know they have the right ideas, we know their executives are coming to the table, but they move like such slow cruise ships. So. So to turn and move the iceberg is not something that they can do. And so we're, we're constantly taking on ice and taking on water. Right. Due to the speed at which these payers can move, I think operational Execution I think they're, they're dealing with, you know, it's, it's tough recruiting environment to recruit talent into health insurance or into any of the payer side or provider sides of health care due to all of the things that are they're facing. So being able to have the right resources to solve the problem and to do it quickly is I think two of the things that are not aligned. The strategy is starting to get there. The ability to execute the, the operational strategy on time where the market's at is not there.

[B]

Absolutely. You don't just need the right strategy or solution. You need that, that quick execution these days. Something else I want to ask Brandy is what's one investment or initiative you believe will most reshape how health plans operate over the next two to three years?

[C]

Yeah, I think an investment in one. Taking a look at their compliance narratives, I believe there's still a lot of administrative mindset or long tenured individuals inside the payer systems that believe they have to receive a fax. Right. And so taking a look at some of that older mindset looking at where is the compliance, where does it really sit? Is there a way that we can do this in a more effective manner that's less administrative lift on all parties and that can be executed operationally efficient. The other thing I think is is going to make a difference is an ability to recruit top talent into this space that want to solve this problem with the right motiv. And I think that will overwhelmingly reduce the cost of delivering healthcare or at administrating at the payer side.

[B]

If you can change one regulatory or industry practice tomorrow so very, very quickly, very soon to improve affordability and access. What would it be and why?

[C]

This is going to be a little self serving but I would correct the lowest cost silver affordability guidelines do not be on the on exchange product. That could be heavily regul and changed which is what we experienced recently and have that be on in a way that it could be charged. The affordability could be calculated on the off exchange silver product for the employer. That would move speed to quote in this environment. It would also accelerate a pace for employers to be able to make decisions and make choice available to their employees and drive consumer accountability and healthcare decisions with those employer dollars and with their own dollars that are coming out of their paycheck.

[B]

And the last thing I wanted to ask you Brandy, what issue is putting the most pressure on health plan margins right now and how are you responding differently to that this year in 2026?

[C]

Yeah, I think for health plans, overwhelmingly there's just, there's 10 people in the food chain before access to care is even there. So the, the provider of the care, so the physician, you know, they've done years of medical school and they want to be able to provide the right outcome for their patients and they're driven by the right motivators. However, they have to see a huge number of, they have to follow a set of rules to even be getting that preauthorization to be able to provide that care to their individual patient. So those providers or those payers need to be able to deliver those answers quicker. And I don't think AI is the answer. We've seen a lot of incorrect denial rates and, and a lot of items that have caused risk there. I think what we need to do is get out of our own way in some of those routine care access challenges. I think the health plan margins are for any health plan to grow, they I heard the stat at Becker's Healthcare and I would misquote it if I tried to quote it right now, but it's, it's basically they've got to grow by 3 admins for every X percentage of the health plan growth. And that's because of the lack of efficiency and operational efficiencies in the system. I think the other thing we've got to stop doing is inserting middlemen into all of the processes. So one of the things that we do here to remove that pressure is make sure that we're going direct to the health plan. So the technology, our technology connects direct to that health plan and we are admitting directly to that health plan. And so reconciliation can happen between those same two parties who are accountable. When you insert multiple people into the food chain or into the cost of service, you have multiple break points. You also have a cost for each one of those solutions. And so that drives up the cost. In most instances it's 10 to 15, 15% in all of the people that are receiving some portion out of that health care plan that doesn't have anything to do with the access to care for the member. And so I think that those are the, those are the pressures they're receiving. That's what's affecting the margins and their ability to respond and respond quickly and have the talent at the table to deliver a less administrative outcome that is still meeting compliance and think outside of the 30 year box that has been built around the payer system is going to be how we improve those margins and we improve access.

[B]

Well, Brandy, thanks so much for sharing your great and unique perspective with us. It was awesome to have you on a podcast. It was a wonderful conversation. Look forward to you speaking with Beckers in April.

[C]

Yeah, I'm looking forward to it. And I can't wait to hear from more health plans that are looking to solve the problem. Thought sharing is how we're going to solve this problem.