9 hours ago
- Business
- Business Journals
3 simple steps for employers to lower health care costs and ensure better employee care
It's no secret that the current health care system is unsustainable. Nearly half of Americans receive health care coverage through their employer and over the past two decades, employer-sponsored health care costs have risen by over 200%.
Many businesses can no longer front the costs — and the burden is being shifted onto employees. The result? Health care has become unaffordable for many working Americans — for some employees cost shifting has made engaging care unaffordable and 40% of American adults are struggling with medical debt — a shockingly high number.
Despite this astronomical rise in cost, most brokers and benefits consultants haven't changed the solutions they present to clients in decades. In our experience, only about 5-10% of brokers are offering their clients innovative alternatives and even fewer have fully embraced a different approach, leading to poor implementation and support when they do try something new.
The reality is that health care operates as an inefficient market. Unlike most industries, higher costs do not necessarily equate to higher quality care — in fact, it can often be the opposite. We believe that by being proactive, transparent and strategic, employers can reverse this trend by reducing costs while ensuring their employees receive top-quality care. However, achieving transformational results demands a completely different approach.
The four of us have spent years in this industry and have tailored a unique approach that enables us to achieve superior results. We've seen what works and what doesn't and the ineffective options continually peddled to employers. That's why we've joined forces to help employers to take control of their health care spend and save real money.
Our approach
We don't believe in a one-size-fits all health plans and we partner with HR leaders to bring their health care strategy to life while directly administering the change. This includes educating employees on what they need to know to make the most of their benefits. When you show people exactly how they can receive better care at a lower price, everyone wins.
Our model is built on three pillars: education, pharmacy platform and Medicare Plus.
Education: We empower members to navigate the health care system effectively and steer them towards high quality and cost-effective options. Navigating the health care system is hard and we take a hands-on approach, which helps members understand their choices and make informed decisions. This extra effort improves health outcomes while ensuring the best experience possible. According to publicly available data compiled by Image360, CT scans in Tampa, Florida, are typically billed between $4,500 and $9,700. Even after PPO discounts, health plan members and businesses still pay $2,200 to $4,800. The problem is, there's little transparency in pricing and high cost doesn't guarantee high quality. Imagine360 changes that. With Imagine360, the average cost for the same CT scan at the same facility drops to under $200. This translates to significant savings for the employee and the business.
Pharmacy platform: Pharmacy spend is the fastest-growing expense when it comes to a health plan. Traditional solutions often lack transparency and instead function as profit centers. We craft innovative solutions to manage pharmacy costs, ensuring that members have access to affordable medications without compromising on quality.
Medicare Plus: We provide a thoughtful alternative to conventional PPOs. This model offers robust coverage at significantly lower costs by anchoring reimbursements to fair, Medicare-based rates.
The above approach collectively has proven to cut costs by nearly 25% on average.
Through this approach, we've reduced the cost of health care so drastically that some clients now offer no-cost health care to all of their employees. At a time when most companies are forcing employees to pay upwards of thousands of dollars per month on health insurance premiums, our clients pick up the full cost of premiums for their employees. This difference is life-changing for many families.
By adopting a three-pillar approach to health care benefits, these businesses have become highly sought-after employers in their communities. And it's not just beneficial for employees — it's advantageous for the health plan as well. When health care premiums are overpriced, only the highest utilizers enroll, which makes sense; you would only pay thousands of dollars a month in premiums if you anticipated high health care expenses. However, when coverage is affordable and well-structured, everyone participates, creating a healthier, more predictable and sustainable plan.
If this sounds too good to be true, you're not alone. One employer came to us frustrated and skeptical. Every broker had pitched the same traditional solutions, none of which solved their problem. Their chief financial officer knew that if they could not control hospital claims costs, the business would be in trouble. We introduced Medicare Plus pricing as a strategic solution. We helped manage the learning curve for the first few months — but once leadership committed to the solution, the plan started working. Three years in, premiums, deductibles and copays have all dropped. Employees are getting better coverage, and the company has even added new benefits — while most of their peers are cutting back.
Using an independent TPA
Working with an independent third-party administrator (TPA) opens the door to a different and better playbook. Yes, it takes more work upfront — more education, communication, teamwork — but the payoff is worth it: a more flexible employee benefits solution that can lead to better care, lower costs, and long-term consistency. No more carrier swaps or yearly overhauls. We currently support 25 clients on this platform.
With dedicated service teams, personalized enrollment education and long-term strategies, we help employers innovate — without impacting employee satisfaction. The result is a smoother, more positive experience.
The road ahead
We're all fighting the same fight: pushing back against a system that hides cost, limits choices, wastes money and is driving people to choose little or no coverage due to cost. But it doesn't have to be this way.
With a three-pronged approach including employee education, pharmacy and Medicare Plus pricing, we're helping employers take back control of their health care costs. By putting people first and staying committed to value-based solutions, employers and brokers can finally break free from the old playbook — and build something better.
McGriff is a Marsh & McLennan Agency LLC Company. Our solutions include commercial property and casualty, corporate bonding and surety, cyber, executive risk, management and professional liability, captives and alternative risk transfer programs, employee benefits, small business and personal lines insurance.
