John Sbrocco is a forward thinking healthcare risk manager and benefits consultant that has built hisreputation on transparency and delivering results. John’s clients point to his ability to implement complex risk management solutions in a way that’s easy to understand, actionable and more importantly, measurable. I had a chance to speak with John after an implementation call for a new employer group and ask him a little about his thoughts on the industry.
Rick Ramos: What is your biggest struggle in benefits right now?
John Sbrocco: The biggest struggle right now is breaking the status quo mindset of employers. They have been brainwashed by the BUCA insurance carriers that they are friends and must rely on them for access to affordable care. When presenting solutions to employers that can cut their healthcare costs year 1 by 20%, their biggest concern is disruption to the employees. However, by continuing with the status quo, employees continue to see rising out of pocket limits and premiums increasing by double digits annually. Most employers don’t realize, due to benefits increases, their employees are making less money now than they did 5 years ago. So, my question to them is, which is more disrupting? Employers continue to think that carriers coming in to buy their business annually is a viable solution. We all know that only works for so long until it explodes. The employers that have the best outcomes over time are ones who break the status quo mindset and implement the most innovative cost containment solutions that provide employees richer benefits and lower costs. These solutions sound like no-brainers for employers, but you would be surprised how many won’t dare to break the status quo.
I know you’ve moved a lot of companies over from a fully-insured health plan to a self-funded plan for the first time. What’s the biggest misconception for companies looking to make the move?
Honestly most just don’t understand the concept or have never been introduced to it. I believe it to be the fault of their incumbent broker. They seem to think of it as too risky, and there is no insurance in place at all. Should something go wrong, they are on the hook for everything. The reality is, almost all self-funded employers purchase some level of stop-loss insurance that protects them from unexpected claims. Each employer knows their maximum liability going into the plan year just like fully insured plans. The difference is they now have control and can retain any unused claims dollars, rather than giving them to the insurance carrier. We are now able to teach them how to manage their risk just like they do in every other aspect of their business.
I loved your video interview from the World Healthcare Congress 2017 where you said companies need to get to the root issue and start managing claims cost. What strategies are you using to help companies?
It starts with an advocacy tool that provides quality and transparency to members when accessing care. How can we expect to contain cost when no one has any idea what things cost? So, you must start by providing members with a tool that gives them their own personal concierge in hand. What better way than through your phone, which the average person checks over 50 times a day. HealthJoy allows me to implement all our risk management strategies into their app, so I can provide full transparency and advocacy to the members when in time of need. We have been able to build strategies that offer $0 copay MRI facilities, $0 copay prescriptions with ScriptSourcing, and $0 copay doctor visits. Employees and employers have been thrilled with the results.
So, what should a company look for in a good benefit consultant?
What we find is employers are looking for consultants who can meet the employer’s needs. So many employers are looking to mitigate spend without compromising benefits. Consultants with the right tools in their toolbox are able to bring these solutions to companies. When incentives are aligned between the consultant and employer, the results can be phenomenal. We have created The Achieve Health Alliance that is turn-key for not only employers but like-minded consultants as well. Our goal is to help employers achieve negative trend and richer benefits.
This interview has been edited and condensed for clarity.
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