Attention: CEOs, CFOs, Business Owners, & HR Execs
Book Reveals How Misaligned Incentives, Corporate Greed and Irresponsibility
Caused a Blind Spot on Your P&L.
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What If You had the ability to substantially reduce one of your largest corporate expenses?
From: Michael M. Adams
Mid-way through my career, I became aware something that shook me. I realized I was a marginally effective benefits consultant.
I tried to win new clients by giving away HR software, offering to do in-person benefit enrollments and helping their employees file insurance claims.
I had a desire to bring real value and become an asset that my client valued. I felt like each time I met with a prospect or one of my clients, I was on the opposite side of the table. They had desires, goals and dreams and I was just pushing a carrier’s product.
I wanted to find a way to sit on the same side of the table as them and become a true business partner. A partner that would last through good times and bad… one that wouldn’t be replaced when another consultant brings in a new shiny object.
At the time, I was struggling with the fact that I saw value in the things I did for my clients, but the owner’s and leadership of those client’s didn’t. That meant that I was always in jeopardy of losing a client to a competitor. Furthermore, the prospective employers I met with saw the HR software, benefit enrollment support and employee claims support as a feature and benefit of having any broker.
I began to see that all my competitors were doing the same thing. I was becoming a commodity. They didn’t really see anything that separated me from any other vendor they had used.
To make things worse, this made me feel like the last few years of my business life was a waste. I struggled to differentiate myself in the market but ended up just blending in. I was doing things that the employer didn’t value and could easily get from any broker in the market.
Then I had some employees leave my company and I felt like giving up. This meant that I had client’s question if our company would stay in business, we even had some of them leave us. We took a substantial loss in revenue and had to make a choice to throw in the towel or search for a new path forward...
Then, as if by chance, something amazing happened...
I found myself in jury duty reading random articles on LinkedIn. I stumbled across an article about a company that had significantly lowered their health insurance cost by improving the benefits the employee’s received.
This employer understood that money spent toward employee pay raises elevate their overall cost (after including payroll taxes) but money allocated toward the group health insurance plan resulted in reduced overall cost because it was a tax-free benefit to the employee. Employee’s saw this as a raise because they weren’t crippled with the out of pocket expenses associated with the company’s health plan.
I thought to myself “this is impossible…. I should tell my clients to lower the deductibles, lower or eliminate copays, make many prescription drugs free, and healthcare cost go down?”
It was now crystal clear… I could revitalize my business if I could learn how to lower an organizations healthcare costs by making the health plan better
I figured that, since I was stuck in jury duty all day, I could research what I thought was an impossible topic, “how to lower healthcare costs while improving the benefits”.
I knew that if I could figure this out; employers would be given the opportunity to choose to simply save the money, significantly improve the health plan benefits, increase the company’s 401k match, or achieve whatever other goals they had with this newly found opportunity. I knew organizations would finally be able to control what most believe to be an unmanageable expense
As a result of my research, I ended up on a call with a physician about a company he had recently started. He led a team that audited medical bills for self-funded health plans and told me a story that has stuck with me throughout the years...
He found a medical bill in which the hospital was charging the employer’s health plan for two permanent cardiac pacemakers. There was a problem—it was for one person and humans only have one heart. So, why would a hospital bill for two?
This physicians’ company received the hospital bill before the employer’s health plan paid the claim. After reviewing the itemized bill and patient medical records, he reached out to the hospital and pointed out the billing issue. After the mistake was realized, the second, unused pacemaker was removed from the patient’s bill
Since the patient only pays up to their max out-of-pocket, 100% of the savings was realized by the employer (because the plan was self-funded).
Said another way, if the member in this scenario had a max out of pocket of $10,000, they have no way of knowing that such a large bill was artificially inflated since the insurance picks up everything after the $10,000 (in this example). Furthermore, the patient has no incentive to see the total bill reduced since they won’t have to pay anything past their $10,000 responsibility.
I asked the physician that audited the bill, how much a pacemaker was. He told me about $50,000 on average. I was noticeably shaken. I said, “So, you saved the employer $50,000 since you were able to get the 2nd pacemaker removed from the bill?” He replied, “Well, we charge them a small part of the savings after it is realized, but yes.”
Suddenly, I thought, “What other items can be found inside a company’s health plan to lower costs?”
The Plan...
Nobody believed me… the market had been telling organizations they can lower their health insurance costs for years.
These organizations were living with a familiar routine, one that says "we will help you lower cost", but instead, the organizations inevitably pay more from year to year. This caused these very same employers to argue for their limitations and surround themselves with other employer organizations that were doing the same.
I understood this whole process had actually strengthened relationships with their large name brand vendors, brokers and carriers. These entities had been reinforcing these limiting beliefs and further ingrained their emotional attachment.
They told them that if they shifted to a high deductible plan, implemented a wellness program, carved out a pharmacy chain or “shopped the market” every year that it would produce savings. In fact, I learned that nearly every broker was singing the same song, “make us your broker and we will save you money”!
In fact, I even began to see a pattern… organizations had a series of almost pre-recorded responses. They would say things like:
- The CFO would never approve that...
- The CEO is not involved in employee benefits...
-
We have tried things like this before, but it didn’t work...
-
The owner is a friend of our consultant...
-
I just gather the information and get it to upper management...
-
If this was real, our current broker would have told us...
-
Our company is different...
-
Get us a quote...
I even learned, along the way, that I not only had to get past these predictable and pre-conditioned responses but also had to demonstrate to the employers, unions and municipalities that there was a cartel-like influence that was keeping all of this from them. These cartel-like organizations were the same organizations that sponsored the local little league events, ran national commercials and gave away free flu shots.
I learned that these influential entities were responsible for “managing” a company’s healthcare supply chain. These entities were the large health insurance companies, pharmacy benefit managers, and institutional benefit consulting houses.
In the end, we finally broke through to a few employers that were struggling to fix their company’s group health insurance plan. This allowed us to proof-out all the different ways we knew would substantially improve the benefits and reduce costs. In the beginning, I was just as shocked as the employers when these strategies worked. Many even worked better that even I anticipated.
We even had clients that received dividend checks from there health insurance company. All of them thought it was impossible, even after I showed them how it was done. They were stunned to discover these things had been hidden from them all this time, but now they felt more empowered with the information and the roadmap we had provided them.
All these things meant we could now achieve what we set out to do: measurably, predictably and repeatably reduce a company’s healthcare expense, improve the benefits their members received, and bring true value to the partnership.
As a result of all this work, we were able to achieve the following:
The “before” is what the employers would have paid if there were no intervention, strategy change, or change in workflow, and the “after” represents the actual cost or exposure my client experienced.
*Real life examples. Each healthcare item noted can be situational. Numbers rounded for simplicity and to account for average costs.
What these employers realized, by following my process, was that by reducing the severity, frequency and unit cost of the underlying healthcare claims, you could reduce the cost to insure those healthcare claims. If you could reduce the cost to insure those claims the company could become more profitable, lower their OpEx and increase their EBITDA.
The employees would also benefit by seeing a reduction in their insurance costs, a lowering in their deductible and a reduction in the overall anxiety many employees feel toward their health plan.
Since I understood that healthcare is paid for with company profits, these strategies could not only reduce the organization’s healthcare spend but also help solve some of the other items many companies may struggle with, like employee turnover, recruiting or increasing the 401k match.
My clients could now use their health plan as a
weapon to compete in their market.
When all is said and done, I was able to feel like a true partner to my clients and no longer saw myself as someone who just sold insurance. I was able to show my clients that their health plan can be used as a weapon to free trapped capital, bring goodwill to their members, and a way to gain a competitive edge in their market.
I saw that my interest was aligned with my client’s best interest. I no longer wanted to win a new client just to make more money, I wanted to win new clients because I knew the impact I could make on their bottom line and for their employees.
I realized that if we could reverse the misaligned incentives hiding in their healthcare supply chain, fix all the corporate greed tactics used by the Cartel, and address the irresponsible behaviour I saw in the industry then everyone would win.
I would compel more employers to address this blind spot on their P&L; my clients would save money and the employees of those companies would have a substantially better health plan. I felt like I was bringing immense measurable value and that I really had an edge on my competition.
Here's The Problem:
Many Believe There Is Nothing They Can Do
Americans owe over $1 trillion in outstanding medical debt and borrowed $88 billion for out-of-pocket medical expenses last year. Medical bills are the leading cause of person bankruptcy. 72 million Americans struggle to pay medical bills... premiums and deductibles cost Americans on average 12% of their household income. Also, over 1/3 of Kickstarter campaigns are for healthcare expenses alone.
This financial burden causes extreme financial, emotional and physical stress. These stresses can cause many to miss work, under preform and lead to an overall poor work life.
Furthermore, many organization's worry about their healthcare budget and the impact it has on their bottom line. Their out of control healthcare budget can cause corporate budget uncertainty, reduced EBITDA, missed sales targets, human capital management constraints, lowered profitability, lost opportunity cost or limited expansion plans.
Don't worry, you aren't alone with these thoughts...
This financial burden causes extreme financial, emotional and physical stress. These stresses can cause many to miss work, under preform and lead to an overall poor work life.
Furthermore, many organization's worry about their healthcare budget and the impact it has on their bottom line. Their out of control healthcare budget can cause corporate budget uncertainty, reduced EBITDA, missed sales targets, human capital management constraints, lowered profitability, lost opportunity cost or limited expansion plans.
Don't worry, you aren't alone with these thoughts...
the good news is... Organization's that Follow The strategies Outlined In this book can Fix All Of this.
Many believe there is nothing they can do to manage their healthcare expenses. What's worse, they surround themselves with others that reinforce this belief. The thing is, you can stop and reverse the trend of rising healthcare cost by eliminating the misaligned incentives, corporate greed and irresponsible behavior that occurs in the healthcare supply chain.
you may have the goal to tackle this problem but very few actually make any changes or possess the right perspective to know exactly what to do
The losses you take in healthcare directly impact your profitability, EBITDA, and your ability to compete. By not addressing the problem, large insurance companies, institutional consulting houses, and Pharmacy Benefit Managers will continue to manipulate your healthcare spend to their advantage.
If you ever thought that the government, health insurance carriers, pharmacy benefit managers, drug companies and the system as a whole have “fixed the market,” you’re probably right. They don’t benefit from lower costs; they are all incentivized to keep you accustomed to overpaying.
I Want To Show You Exactly What Is Possible...
Inside My Book, I Uncover What Most Consultants Have Ignored
Learn The Critical Opportunities Within Your Business
The Author
Who Is Michael M. Adams?
Michael M. Adams is the co-founder of Workforce Consultants. For over a decade he has had uncomfortable conversations with organizations about one of their largest budget items, their healthcare plan.
He works as a consultant to employer organizations to expose the dozens of inefficiencies that have caused them to unnecessarily overpay for their healthcare plan. He then advises on solutions that specifically address these hidden opportunities.
The Author
Who Is Michael M Adams?
Simply Send Me Your Address...
I'd like to rush a FREE copy of my brand new book to your doorstep or office. All you have to do is cover the cost of the shipping.
These Expenses, Hiding In Every Business Are Disguised As Liabilities...
But CAN Become A Powerful Asset!
The opportunity to substantially lower your company’s healthcare costs while simultaneously improving benefits may be a new idea to you, but it doesn’t have to be just an idea.
Implementing the steps outlined in Misdirection will make it a reality, giving your organization a competitive edge in your market. Just be sure to read this before your competitor does...
And right now this book is completely FREE. All I ask is that you help me cover the postage and packaging costs which are $7.95 Domestic or $14.95 International.
My hope in writing this book is to pull back the curtain and give you actionable ways to turn a liability into an asset. Not only do we address cost but we discuss employee morale, improving company culture and how all these topics are tied together.
I can only help companies one at a time, but writing this book has allowed me to help many at once. The content this book works for organizations that are unwilling to continue to unnecessarily health plan as a weapon against their competition. The best time to address this was ten years ago, and the second-best time is now.
But time is of the essence. There's a limited number of copies for this promotion and it takes 4 weeks to re-order another batch so this is likely the only time you'll see this page...
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