What is the central aim of the broker-employer relationship?

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Brokers are important stakeholders in healthcare. Their value in working with employers and plan sponsors is well established. The utter complexity of decisions requires deep knowledge of how to match employers with solutions that are now essential to their ongoing viability.

The spend in healthcare for employers, and employees, is now a material consideration for the financial health of corporations, small businesses and families. While much has been focused on differences in costs as a tool to manage spend, the understanding of provider quality is nascent with both brokers and employers.

In my 26 years of experience with medical analytics, the variation in quality is as ubiquitous and of the same magnitude seen with costs. And yet, quality has not been a material part of these purchasing conversations.

If greater value is a central aim of the broker-employer relationship, then it is incumbent upon brokers to become better equipped to understand and address quality as part of their fiduciary role. There are hospitals and physicians who do a statistically better job of avoiding adverse outcomes like mortality, complications and readmissions. This is factual and well established in a wealth of published literature.

Much information on provider quality has been in the hands of providers for decades with virtually no information making it to those who are purchasing healthcare. I know as I have been involved with hundreds of hospitals, and their physicians, using this information as part of their operations and compliance. This inequity is central to some of the perversities we see today with decisions being made based upon reputation, uninformed physician referral, anecdote or simply cost alone.

Emerging opportunity
With no guidance from brokers, employers are left to their own discernment to navigate toward greater value. The numerous, and growing, outlets of information cause confusion and may mislead consumers putting them unknowingly into harms way. This doesn’t have to be the case.

As trusted advisers, brokers have an emerging opportunity to broaden their value to employers by embracing a new expertise around understanding provider quality. I believe that even a basic understanding that can be simply conveyed to employers will enhance current business and put you in a position to grow as healthcare continues into a season of material disruption.

There will be many content to stay within the traditional confines of the legacy business. Some employers have already left on their journey toward value and are seeing reductions in spend and risk avoidance reaping rewards in avoiding catastrophic claims, better employee productivity and the confidence of knowing that you can achieve higher quality with lower spend.

The question for the broker community is would you rather be a leader or a passenger?

Wolverton will speak further on this topic in a keynote panel at EBA’s Workplace Benefits Renaissance on Feb. 28.

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