Episode 508 is the first Ask Me Anything installment of Relentless Health Value, where Stacey Richter and Lee Lewis (Chief Strategy Officer and GM Medical Solutions at the Health Transformation Alliance and host of Broken Benefits) address a question from benefits procurement leader Sarah Monroe about why executives rarely take bold action on health benefits despite large opportunity.

Lewis describes three false C-suite "dogmas" that lead to "stay in the herd and keep it quiet": health benefits are a fixed expense, saving money hurts people (via cost shifting, low quality, or narrow networks), and fixing healthcare isn't worth the risk or disruption. They also discuss external deterrents including CEOs' proximity to health system leaders, "balance of trade" retaliation threats, vendor-provided personal incentives, and executives' limited empathy for deductibles/costs faced by lower-wage employees.

Lewis offers de-risking tactics (same-network TPAs, carrier-enabled vendor changes, narrow pilots, mid-year tests) and advises CEOs to encourage bold action, tie bonuses to plan performance, and staff benefits teams with diverse skills.

=== LINKS === 🔗 Show Notes with all mentioned links:

https://cc-lnk.com/EP508

📺 Visit Lee's YouTube Channel

https://www.youtube.com/@brokenbenefits

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00:00 Introduction to this episode.

00:43 Ask Me Anything Question 1: Why don't more self-insured executives take bold action toward their benefits strategy?

03:09 A summary of the three dogmas covered in the following conversation.

05:53 A look ahead at next week's episode.

06:36 An introduction to today's guest, Lee Lewis.

08:23 Why there is an aversion to digging into health benefits for some executives.

09:43 The first dogma: Healthcare costs are fixed expenses.

09:56 The second dogma: Saving money in healthcare hurts people.

12:01 The third dogma: Fixing healthcare is never worth the effort.

12:26 How these dogmas trickle down to HR teams.

13:47 Anecdote: One company that turned down saving $50 million and why.

16:28 A quick reminder about the context behind where CEOs' mindsets are.

17:10 The kinds of employers HTA seeks out.

19:20 EP500 with Stacey.

20:03 The power of C-suites in health systems.

21:33 EP466 with Vivian Ho, PhD.

21:36 EP404 with Suhas Gondi, MD, MBA.

21:42 Why a CEO may pull the plug on health plan/health benefit improvements.

22:37 An anecdote about Lilly cancelling their health plan.

23:21 Items that CEOs need to be thinking about.

24:33 EP506 with Jerry DiMaso.

26:07 EP501 with Ivana Krajcinovic, PhD.

26:32 A summary of why CEOs should care about their health benefits costs now.

29:02 How do personal incentives play into CEOs' decisions about health benefits?

30:44 Another quick reminder about C-suites.

31:53 Why perverse incentives make it difficult for C-suites to accept change.

33:11 LinkedIn post by Patrick Moore.

33:28 Why the salary gap plays into health benefit decisions in a perverse way.

34:58 EP488 with Mark Cuban and Cora Opsahl.

36:13 Lee Lewis's advice to people in benefits who are aligned to the mission.

40:06 Lee Lewis's advice for CEOs.

Lee Lewis of @HTACOOP discusses #benefitsstrategy for #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast #financialhealth #commercialpayermarketplace #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation

Recent past interviews:

Click a guest's name for their latest RHV episode!

Stacey Richter with 15 experts (EP507); Jerry DiMaso; Dr Ahilan Sivaganesan; Ryan Jacobs; Stacey Richter (INBW46); Ryan Wells, Dr Leo Spector, and Adam Stavisky; Brian Machut; Ivana Krajcinovic