John Sbrocco is a forward-thinking health care risk manager and benefits consultant who has built his reputation on transparency and delivering results. John’s clients point to his ability to implement complex risk management solutions in a way that’s easy to understand, actionable and more importantly, measurable. I had a chance to speak with John after an implementation call for a new employer group and ask him a little about his thoughts on the industry.

Rick Ramos: What is your biggest struggle in benefits right now?

John Sbrocco: The biggest struggle right now is breaking the status quo mindset of employers. They have been brainwashed by the BUCA insurance carriers on whom they must rely for access to affordable care. When I present solutions to employers that can drastically cut their health care costs, their biggest concern is disruption to the employees. However, if employers continue with the status quo, the result is employees facing rising out-of-pocket limits and premiums increasing by double digits annually. 

Most employers don’t realize that, due to benefits increases, their employees are actually making less money now than they did five years ago. So, my question to them is, which is more disrupting? Employers continue to think that carriers coming in to buy their business annually is a viable solution. We all know that only works for so long before it explodes. The employers that have the best outcomes over time are those who break the status quo mindset and implement innovative cost containment solutions that provide employees richer benefits and lower costs. These solutions sound like no-brainers for employers, but you would be surprised how many won’t dare to break out of their old mindset.

RR: I know you’ve moved a lot of companies from a fully-insured health plan to a self-funded plan for the first time. What’s the biggest misconception for companies looking to make the move?

Honestly, most just don’t understand the concept or have never been introduced to it. I believe it to be the fault of their incumbent broker. They seem to think of it as too risky, and that there is no insurance in place at all. Should something go wrong, they are on the hook for everything. The reality is, almost all self-funded employers purchase some level of stop-loss insurance that protects them from unexpected claims. Each employer knows their maximum liability going into the plan year, just like fully insured plans. The difference is they now have control and can retain any unused claims dollars, rather than giving them to the insurance carrier. We are able to teach them how to manage their risk just like they do in every other aspect of their business.

RR: I loved your video interview from the World Healthcare Congress 2017 where you said companies need to get to the root issue and start managing claims cost. What strategies are you using to help companies?

It starts with an advocacy tool that provides quality and transparency to members when accessing care. How can we expect to contain cost when no one has any idea what things cost? So, you must start by providing members with a tool that gives them their own personal concierge in hand. What better way than through your phone, which the average person checks over 50 times a day?

RR: So, what should a company look for in a good benefit consultant?

We find employers are looking for consultants who can meet the employer’s needs. So many employers are looking to mitigate spend without compromising benefits. Consultants with the right tools in their toolbox are able to bring these solutions to companies. When incentives are aligned between the consultant and employer, the results can be phenomenal. Our goal is to help employers achieve negative trend and richer benefits.

This interview has been edited and condensed for clarity.

Rick Ramos is the CMO at HealthJoy, a cost containment healthcare platform that uses an A.I.-powered virtual assistant to proactively engage employees to make better decisions. He is also the author of the best-selling book “Content Marketing.” Connect with him on LinkedIn or Twitter @ricktramos.