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Administrative fatigue

Employer-sponsored healthcare


Q&A with Dr. David Stark

Baruch Levy

February 12, 2024

A conversation between Baruch Levy, CEO and Dr. David Stark, Advisory Board member.

Dr. Stark is a key opinion leader in the realm of employer-sponsored healthcare, and presides over the health and well-being of 80,000 employees across 40 countries, with a comprehensive health plan covering 100,000 members in the United States.

Question:  Why bother with the complex maze of point solutions, when you can offer health plan coverage with their vast network of providers?

Answer: The business case for benefits—recruitment, retention, productivity, and financial and operational risk management—is critical. It's the second leading expensive category after compensation, carrying financial, reputational, and regulatory risks. We select the best health plans and benefits stack to achieve these goals, providing affordable access to high-quality care with a positive user experience. Over the past two decades, traditional health plans stumbled, leading to a surge in point solutions, partly funded by venture capital. These cater to every conceivable aspect, from diseases and conditions to life stages, demographics, and service mixes. Employers embraced this buffet of solutions, with COVID-19 adding an extra serving of telehealth. Now, employers grapple with the weight of a complex, overloaded benefits stack, facing growing risks with data privacy issues and confusion for employees, hindering value production. The shifting economic environment compounds the challenge of demonstrating the predicted value of benefits.

Question:  How do you select which point solutions to offer and measure success in your benefits stack? How do you know what is working for you? 

Answer: Success in employer-sponsored healthcare is not uniform. Individual benefits teams rigorously evaluate the benefits stack, measuring utilization, financials, member experience (NPS), and, most challenging, outcomes in terms of health. This involves significant time and effort, including benchmarking against peers for competitiveness. The quest for improvement extends to going out to the market to find new solutions, conducting RFPs, implementing new vendors, and managing them effectively.

Question: How long does it take for you to onboard a new vendor?

Answer: Onboarding a new vendor can take up to 18 months. The complexity is significant for startups who want to work with large employers, expected to navigate patiently through numerous hoops. Despite the good intent to protect healthcare, the process is intricate and doesn’t work optimally for either side.

Question: On the flip side, how complicated is it to offboard a vendor?

Answer: Off-boarding benefits is both unpopular and challenging, as it involves taking things away from employees. A movement is emerging that challenges the assumption that employers have traditionally paternalistically selected benefits for their employees, and it has been well-established that this is not the case.

QuestionLet’s talk about healthcare consumerism. What will be the fine line between independent consumerism and professionals that guide and manage end-user healthcare?

Answer: Healthcare consumerism has been in vogue due to the inherent principal-agent problem in healthcare experiences. Users are not the direct payers, resulting in a poor end-user experience. Purchasing healthcare is not like purchasing a car. The value is not as directly observable. So, naturally, people make decisions about their healthcare based on the more observable factors like user experience and cost. This makes consumerism challenging, but possible with a focus on the end-user experience, focusing on frequent and directly observable interactions. This shift will engage users with good, solid primary and preventive care - the cornerstone of good healthcare. 

Question: Given that most people are locked into a certain pattern of behavior when it comes to their healthcare, how can we bring this vision to reality?

Answer: There is already a movement towards third-party entities, like Fijoya, creating a marketplace between providers and various services enabling healthcare, with a set of rails bringing payors and providers together. Direct engagement with multiple point solutions is unworkable and unsustainable for the employer. Employees cannot be expected to know what benefits to use at a given point in time. There are so many offerings that are hidden and potential value locked away because of the current state of inefficiency.  A decentralized system will emerge, establishing a new marketplace and system to be held accountable for what is available.


Administrative fatigue

Employer-sponsored healthcare


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