From broker to beacon: Ann Blair Gribbin's advisor journey

"I knew I was working hard for my clients, but I also knew the system was broken," Gribbin recalls. "When you see premiums increase 7% to 10% every year while employers are forced to shift more costs to employees or reduce benefits, you start to question the entire approach."

That questioning led her to a pivotal moment in 2017, when she was introduced to Health Rosetta and its alternative approach to health care benefits. Her client, Russell DuBose at Phifer Incorporated, had read Dave Chase's book "CEO's Guide to Restoring the American Dream" and was convinced there was a better way forward for his 1,200-employee manufacturing company.

The beginner's mind

As Gribbin's journey began, she was familiar with core strategic concepts like funding methodologies but relied heavily on external resources to develop strategic roadmaps.

"When Russell approached me about implementing a Health Rosetta model, I was willing to change but simply didn't know how," Gribbin admits. "I had to acknowledge that much of what I thought I knew about benefits was actually limiting what I could do for my clients."

This honest self-assessment was crucial. Rather than defending the status quo, Gribbin embraced a beginner's mindset. She joined the and participated in a Phifer kaizen event, which offered a Lean Six Sigma problem-solving approach to dissect their health care plan. Together, they developed a seven-year roadmap that would transform Phifer's benefits approach while creating substantial savings that could be reinvested in the company and its people.

The critical first step: Health plan performance review

After the initial kaizen event, Gribbin cognized they needed a more structured approach to assess the current state of Phifer's plan and identify specific opportunities. She recommended a 360° assessment offered by Health Rosetta that would provide actionable insights to transform Phifer's health plan from a cost burden into a strategic advantage.

"The Health Plan Performance Review was the turning point," she explains. "It gave us a data-driven framework to evaluate every aspect of Phifer's plan against market leaders implementing high-performance principles."

The review followed a rigorous five-phase methodology:

Phase 1: Data Collection & Initial Assessment Gribbin worked closely with Phifer and the Health Rosetta team to gather plan documents, vendor contracts, and claims data, establishing a baseline understanding of their current plan structure, vendor relationships, and cost drivers.

Phase 2: Plan Grader & Benchmarking Analysis The team conducted a qualitative assessment of Phifer's plan design against industry best practices. This revealed critical gaps: their plan lacked cost-sharing alignment with employer objectives, had significant employee engagement issues, and contained inefficient structures driving up long-term costs.

Phase 3: Contract & Compliance Review The team performed a detailed analysis of Phifer's vendor contracts, uncovering hidden fees, spread pricing in their PBM arrangement, and stop-loss contract provisions that increased financial risk. They also identified regulatory compliance gaps in their plan documentation.

"When we reviewed these contracts with the Health Rosetta team, we found language that directly worked against Phifer's interests," Gribbin notes. "Many of the provisions actually prevented them from implementing the high-value strategies they wanted to pursue."

Phase 4: Claims Review & Cost Containment The data-driven claims analysis revealed that high-cost claimants represented over 50% of Phifer's total spend, pharmacy claims had significant inefficiencies, and emergency room overutilization was driving avoidable expenses.

Phase 5: Strategy Development & Implementation Roadmap The team then synthesized all findings into a clear, actionable roadmap with specific timelines, ownership, and accountability measures. This became the foundation for Phifer's seven-year transformation plan.

"The report quantified over $2 million in potential savings over two years," Blair says. "But more importantly, it gave Russell and his team confidence that we had a structured, proven methodology to achieve these savings while actually improving benefits."

Growing to competence

With the review as their guide, Blair and Russell began implementing the roadmap, starting with the creation of the PhiferCares Clinic. Phifer opened their PhiferCares Clinic in February 2019, offering zero cost-share advanced primary care to all plan members. Within six months, daily capacity averaged 88%, with 58% of eligible users actively using the clinic.

"The review allowed us to prioritize initiatives that would have immediate impact," Gribbin says. "By focusing on high-value primary care first, we created early wins that built momentum for the entire transformation journey."

Gribbin was now able to effectively communicate the relationship between different components of the health care plan and provide clear written and verbal guidance to her clients.

The proficient practitioner

The COVID-19 pandemic could have derailed Phifer's health care transformation, but instead, it highlighted the value of their new approach. The PhiferCares Clinic became the front-line defense against the pandemic, offering support to the workforce and their families. This crisis period also accelerated Gribbin's growth and education.

Gribbin developed extensive strategic knowledge in advanced approaches. Through her hands-on experience with Phifer and continued guidance from the Health Rosetta team, she developed and implemented strategic plans, anticipated and mitigated risks, and provided guidance to less experienced consultants.

Following the roadmap, Gribbin guided Phifer through the next phases of implementation in 2021. She helped them develop direct contracting relationships with high-quality health care providers, implement a wellness program, launch an onsite physical therapy program, and create a data warehouse solution for ongoing performance monitoring. She also led them through a transparent pharmacy benefits manager selection process, resulting in significant savings and improved care.

"The ability to use data effectively became one of my most valuable skills," she notes. "The performance review established our baseline metrics, and now we could track our progress against those benchmarks to prove the ROI of each initiative."

The expert advisor

Today, Gribbin's advisor education has reached the point where she can functionally provide strategic advice and consultation regarding all key components of an innovative benefits program, including transparent networks, patient stewardship, value-based primary care, plan management, pharmacy benefits, and specialty care.

Her deep familiarity with the vendor ecosystem, solution providers, funding methodologies, and their respective pros and cons allows her to establish multi-year benefits roadmaps for her clients. The education she received on the job through her collaboration with the Health Rosetta Client Success Team has given her the knowledge and confidence to identify inefficiencies and implement effective solutions for her clients.

The transformation of Phifer's benefits program stands as a testament to Gribbin's journey. Under her guidance, Phifer's Plan Grader score improved from 37 (above average) to 74, representing a dramatic improvement in plan quality and performance. More importantly, the company has created a "health care dividend" that has funded:

• Scholarships for over 100 employee dependents
• A summer enrichment program benefiting more than 200 children
• Elimination of pharmacy copayments, helping over 1,700 patients
• An onsite chiropractic and imaging center
• Plans for childcare assistance for 250+ plan members

"The health care dividend concept brings the health plan performance review full circle," Gribbin says. "We identified financial opportunities, implemented strategic changes, and now those savings are being reinvested in ways that create profound human impact."

Continuous innovation: addressing obesity & morbid obesity

As the relationship between Gribbin and Phifer deepened, she continued to identify new opportunities to enhance their health care approach. In early 2023, she helped Phifer address a growing concern revealed by their claims data: despite the success of their Phifer Fit wellness program, obesity and morbid obesity claims were increasing year over year.

Gribbin recognized that while 90% of their population (approximately 1,710 participants) were actively using the PhiferCares Clinic, only about 18% (300 participants) were enrolled in the Phifer Fit program. She worked with the Phifer team to develop a comprehensive four-pronged strategy:

1. Health coach-based navigation: Phifer hired a nurse health coach with nutrition certification to coordinate with the PhiferCares Clinic, providing personalized guidance and creating a bridge between clinical care and lifestyle changes.
2. Nutrition and upstream activities: Phifer evaluated company policies around food options in break rooms, vending machines, and catered events, promoting healthier alternatives and creating an environment that supported better nutrition habits.
3. Additional clinical resources:  The health coach also expanded educational resources through group sessions and individual coaching, complementing the work of the PhiferCares Clinic staff.
4. Overall communication strategy: For the program to be successful they established a comprehensive communication approach that included a formal introduction of the health coach, regular wellness communications, and the creation of a wellness committee with representatives from all levels of the organization.

"The obesity strategy exemplifies how Blair continues to help Phifer evolve their approach," Russell explains. "Rather than just focusing on treating obesity-related conditions, we're creating a holistic environment that makes healthy choices easier and more accessible for our employees."

This initiative is expected to further reduce costs while improving health outcomes, adding to the healthcare dividend that Phifer continues to reinvest in their workforce.

Paying it forward

Ann Blair Gribbin's journey from traditional broker an innovative benefits advisor hasn't just transformed her clients' benefits programs; it has also transformed her entire approach to her profession. She now mentors other advisors within CAC and actively participates in the Health Rosetta Advisor Network, sharing her knowledge and experiences to help others follow a similar path.

"The health plan performance review isn't just about finding savings—it's about creating a strategic vision for what's possible," she says. "It gives employers the data they need to make confident decisions and the roadmap to implement changes in a way that builds on each success."

For employers considering their own health care transformation journey, Gribbin offers the same advice she received from Russell DuBose years ago:

"Start with an honest assessment of your current plan. Then invest in a Health Plan Performance Review to develop a comprehensive roadmap. Find an advisor who is aligned with your interests and ready to be a true partner in transformation. The path isn't always easy, but the human and business impact makes it worth every step."