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Musings of an old disruptor: What is a Partner?

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As a member of the Rosetta I was intrigued by the idea of an organization dedicated to working with employers and vendor partners to begin bending the curve of healthcare spend. Many of us had been employing tools for a number of years and occasionally would run across another likeminded consultant. It was always exciting when that happened because it gave you the opportunity to compare notes and share what worked. You were not particularly worried about competition; you just wanted someone to share the vision.

During that time, you were trying to find vendor partners that would share your ideas and try to do some things that at the time, seemed way out of the box. The ability to find them was like looking for gold, and they were just as valuable. It was during this time that I learned what a partner is. You see, there were times when others and I were way out over our skis. There were times when something you thought was a great idea, was just the opposite. Times when you had to pick up the phone and say I need a favor. Times when you sat down together and said how do we do this, only to find out you were both wrong.  It was in some respects, the wild west!!!

Therefore, I was excited to see the Rosetta come into being. A group dedicated to the idea of likeminded consultants, great vendors and forward thinking employers all working together.  Put another way, partners.

So, what is a partner?  A partner is family…..period.  Someone you look out for, you lift up, you coach up, you consult with, you point out their weaknesses (but only in private).  Someone you want the best for, will give multiple chances to and someone with whom you are always honest.  Put another way, someone you value and are dedicated to!!!

Lately, I have seen post not treating some of our partners as partners.  This is a closed forum and I am not sure some of those partners can even read the post much less share any mitigating thoughts.  This causes me a concern.  While we need to be able to share all of our experiences both good and bad, it is important that they be provided with context and that the partner has a chance to speak.  If we do not treat our partners as partners, then soon we will have none. 

You might wonder why these thoughts come clearly to my mind.  It is so very simple.  In another time, I was that partner.  I was way outside of the box I knew.  I caused anguish for some of the vendors with whom I worked.  It took a long period for me to grow to where I am today and I made and still make many mistakes.  Yet, without exception, those I had chosen to work with gave me chances, coached me, consulted with me and valued what the relationship could be.

Dominoes They Are A Falling

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If you choose not to read at least watch the video below!!

Having just returned from the 2018 World Health Care Congress, I now feel more focused on the job at hand than ever before. I define the job at hand as, helping employers restore predictability and sustainability to their health care supply chain, while at the same time, greatly increasing employee satisfaction in and around the benefits they are provided.  In addition to my Rosetta cohorts, there was a seemingly unlimited number of healthcare innovators in attendance. Doubtless, a number of these start up innovators will fail. While they may have great ideas, implementation, scalability, lack of long-term value and ill-defined value propositions will take a toll. However, there will be a number who will not only survive but thrive, in a market designed around a transparent health care system.

In addition to the innovators in attendance, there were also a number of traditional market players. Those most focused on more of an add on approach to the traditional contract / PPO plans. The thought process in this group very seldom includes dealing with the cost of care, but rather with managing access, deeper discounts, more restrictive contracts and continued lake of transparency.

While I strongly align with the innovators, there is value in understanding the approach and beliefs of those in the other camp. The insurance industry has done an exceptional job of defining and setting the rules of the game. Employers are at least comfortable with the rules, even if they are most uncomfortable with the results of the game. The results being in the majority of cases, higher premiums, deductibles, co-pays, out of pocket, employee cost and decreased overall satisfaction.

If you are a business owner I encourage you to connect and look forward to an upcoming series of short articles and videos on the “Evolution to Health Care Transparency”. Some will be by me, some by other consultants and some by industry leaders. I promise no solicitation, just a venue and opportunity to learn.

It is my assertion that the first domino has fallen. Many early adapters in the business world have already changed how their companies approach the financing of the “health care division” they never wanted but now have.  They are now managers of a health care supply chain, not simply purchasers of health insurance. These changes are allowing them to save 15 to 30 percent annually and hold future increases to 1 or 2 percent. These savings allow for greater business investment, improved infrastructure and additional capital. In other words, these early adaptors have a very real competitive advantage over many of their peers.

Health Insurance No More – Now Health Cost Funding

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THE GAME IS CHANGING ARE YOU LEARNNG THE NEW RULES?

Sometimes the longer we do something the more we become entrenched in the ideas, processes, solutions and paradigms we’ve created and espoused for years. It occurred to me during a conversation with a client, I too, had fallen into the trap.   I still catch myself referring to a client’s health care funding strategies as health insurance. Although, based on the definition above, that is quite the misnomer. If there is one thing that is certain, it is that medical claims begin to incur the very moment any funding plan / policy / contract, goes into place.

With this understanding, it becomes clear that the portion of funding going towards real insurance is actually fairly small. If a particular employer has 1.5M in known exposer, i.e. known diseases, known surgeries, know pharmacy spend etc., that is not insurance. We are now looking for the most cost efficient way to pay known expenses.  In the past, we have relied on the insurance carriers to pay those expenses. However creative and nontraditional thought is changing that paradigm.  Question – do you as a business owner, in areas other than healthcare engage an outside third party, profit motivated entity, to pay your known obligations? Answer – I doubt it.

Suffice it to say, the traditional approaches are being questioned.  Employers and consultants are looking for more efficient ways to pay for healthcare.  Many of those ways include returning to the purchase of actual Healthcare not Health Insurance.  Finding ways to put the provider and the payer together rather than keeping them separated as the current model does.  There has never been a better time to ask the questions why and why not.   If you have questions, let me know!