Brokerage targets healthcare management for firms with tight margins

Adviser Mike Hill is looking for employers who want to get their hands dirty. With health insurance becoming increasingly expensive, Hill and the team at Coldbrook Insurance Group in Grand Rapids, Mich., have been looking for an alternative solution to the standard, fully insured system, and the right employers to participate.

To bring that vision to life, they’ve developed in recent months a division of Coldbrook known as Total Control Health Plans. TCHP is designed to appeal to employers who want to explore alternative ways of funding their healthcare plans that treat benefits the same way they’d treat any other unit of their business: Identify their plan’s specific needs and tackle the healthcare supply chain management to achieve the desired results — lower costs and increased satisfaction.

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“The idea is, if an employer is willing to roll up their sleeves and get their hands dirty and use the same strategies they use to manage all other aspects of their business on their health plan, they can achieve a different result,” says Hill, who runs the Total Control Health Plans division for Coldbrook.

TCHP is in line with Coldbrook’s leadership principles, says company co-founder Jim Watson. “Coldbrook has always been an industry leader, whether it being early adopters of consumer-driven plans, bringing self-funded solutions to small employers, or using strategies like reference-based pricing,” he says. “Launching Total Control Health Plans was simply an evolution of our commitment to innovation.”

Hill recently wrote a book on the concept, “Not Rocket Surgery: An Employer’s Guide to Controlling the Health Care Supply Chain,” that will soon be available for purchase on Amazon. He describes it as a very short conversation when speaking with employers about the self-funding method behind taking control of their health spend. “Either they’re open to the idea, or not,” he adds.

For those open to it, no two TCHPs look the same, as the idea is to identify individual clients’ particular needs and bring in appropriate partners to achieve those results. For example, practices include leveraging direct contracting, bulk purchasing, medical tourism, transparent PBMs, manual claims analysis and other supply chain management concepts that mega-size employers have been doing for years.

See also: In a broken healthcare system, an adviser offers custom medical plans

In an example shared on the TCHP website, an employer saved nearly $80,000 on one of its plan participant’s in-patient hospital stays by simply using a human-based detailed claims payment model rather than the standard auto adjudication practice utilized by most insurance carriers.

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“The TCHP model has given us the ability to use the same entrepreneurial, strategic management practices we have used in all other aspects of our business. As a result, we are now in the position to implement a health plan that aligns with our culture and values,” says Coldbrook client Mat Nguyen, president of Worksighted, an IT firm in Holland, Mich., with 85 employees.

One prospective customer Hill attempted to bring onboard several times in the last decade always turned him down, saying he wasn’t presenting anything new or different enough to justify severing their relationship with their longstanding broker. Then, Hill presented the TCHP model. “Giving the employer the understanding that they in fact can control the various components of the healthcare supply chain and can have a meaningful impact on costs was something they had never heard before and was very appealing to them,” Hill says. Two months ago, he earned the AOR.

When his book is released, the top objective is not to sell as many copies as possible, but rather share it with targeted employers who are likely to benefit from the concepts it promotes, Hill says. Top prospects include industries with small margins, including trucking, manufacturing and other fields, “where you're making millions of parts a year and you're getting a fraction of a penny on each part,” he says.

“If we can not only provide your employees with a better plan — which I believe that we absolutely can — but also reduce the costs for both employees and the employer,” he says, “that's a meaningful and attractive concept that we're getting traction with.”

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