In Episode 509 of Relentless Health Value, Stacey Richter interviews former CFO and Aligned Marketplace CEO Patrick Nelli about why executives don't take bolder action on health benefits and offers a seven-step roadmap to align finance teams with non-complacent benefit design.

Key steps include ongoing CFO-benefits engagement, forecasting medical trend accurately at 7.7%+ (two to three points above CPI) as the status-quo baseline, and presenting win-win alternatives to bend the cost curve. Nelli explains employer medical inflation drivers including Baumol's Cost Disease and cost shifting from Medicare to commercial, and argues proven strategies like independent advanced primary care can reduce unit prices, downstream utilization, and future high-cost claimants.

Additional steps cover aligning incentives with safeguards, optimizing contracting (including direct contracting), and steering/tiering via risk stratification to focus engagement on high and rising-risk members. Nelli describes Aligned Marketplace's national value-based advanced primary care and specialty marketplace.

=== LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP509

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00:00 Introduction to this episode.

02:48 Roadmap Step 1 highlights.

03:07 Roadmap Step 2 highlights.

03:49 Roadmap Step 3 highlights.

04:15 Roadmap Step 4 highlights.

04:27 Roadmap Step 5 highlights.

04:58 Roadmap Step 6 highlights.

05:19 EP504 with Ryan Jacobs.

05:37 Roadmap Step 7 highlights.

06:28 Introduction to the conversation with Patrick Nelli.

06:36 Step 1 to Patrick's roadmap: Open the conversation.

07:57 What Patrick thinks is sometimes missing in health benefits.

09:07 What finance teams need in order to change their behaviors.

09:53 What Baumol's cost disease is.

10:58 EP341 with Gary Campbell.

11:14 EP492 with Sam Flanders, MD, and Shane Cerone.

12:18 The second item stacked against employers: Being price "takers."

13:49 The percent inflation employers should expect if they follow the status quo.

15:39 INBW46 with Stacey.

16:54 Proven strategies to bend the health benefits finance curve.

18:42 EP391 with Scott Conard, MD.

19:37 SUMS11 with Stan Schwartz, MD.

20:18 How employers and plan sponsors can bend the cost curve.

21:47 The two distinct business models that finance teams need to consider when setting up their health benefits model.

24:11 Milbank study on the role of primary care.

24:53 A quick reminder of high-cost spending within health plans.

25:00 EP466 with Vivian Ho, PhD.

25:10 EP464 with Al Lewis.

25:59 What finance teams need to hear right now to understand why disrupting their health benefits plan is worth it.

27:45 The next step when an employer recognizes that they should seek out an advanced primary care option for their members.

28:41 EP503 with Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky.

30:27 Next steps after an employer enlists an advanced primary care system and aligns values and incentives in their benefits plan.

34:26 A last word to benefit teams working with finance teams.

34:55 EP430 with Barbara Wachsman.

35:08 How Aligned Marketplace fits into this entire conversation.