Understanding Healthcare's Flaws and Finding Solutions with Michael Menerey, SVP of Alliant Insurance Services
Sep 10, 2024
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Michael Menerey, Senior VP at Alliant Insurance Services, shares his insights on the flaws of the traditional healthcare system. He discusses the critical need for price transparency and quality metrics, emphasizing that employers and employees must advocate for change. The conversation shifts to the advantages of self-funded health plans, highlighting their potential to control costs and improve care quality. Menerey also stresses the importance of tailored communication strategies to cater to diverse workforce demographics, ultimately enhancing the member experience.
The traditional healthcare system suffers from severe inefficiencies, particularly due to a lack of price transparency and misaligned provider incentives.
Shifting to self-funded health plans allows employers greater control over healthcare costs and the opportunity to enhance the quality of care for employees.
Deep dives
The Flaws in the Traditional Healthcare System
The current healthcare system is characterized by a lack of price transparency and inherent inefficiencies. Unlike other industries where consumers can compare prices and access quality metrics, healthcare presents a confusing landscape with significant cost discrepancies. For instance, a patient may be quoted $2,500 for an MRI at one facility while a nearby alternative charges only $500, showcasing a staggering difference in pricing. This indicates broader issues, including misaligned provider incentives and a system design that does not prioritize patient education or transparency.
Resistance to Change in Healthcare
Incentives play a crucial role in the slow pace of change within the healthcare system. Providers are primarily motivated by financial incentives that often prioritize profit over patient wellness, making it challenging to enact meaningful reform. Similarly, insurance companies continue to operate under traditional profit-driven models, resulting in cost increases being passed on to employers and employees with little incentive to curtail expenses. Ultimately, it is the employers and employees who are in a position to drive change, as they bear the financial burden of the current inefficient system.
Benefits of Self-Funded Health Plans
Employers are increasingly shifting from traditional fully insured plans to self-funded health plans to cut costs and enhance control over their healthcare offerings. Self-funding allows employers to eliminate unnecessary profit margins built into fully insured products, providing a path to more cost-effective health benefits while improving the quality of care available to employees. Engaging in self-funding also opens up a variety of cost containment strategies, such as direct contracts and network optimization tools that enhance member experiences and health outcomes. Over time, self-funded employers have been shown to fare better financially than their fully insured counterparts, particularly as they implement innovative healthcare solutions.
Enhancing Member Experience in Healthcare
In the evolving healthcare landscape, enhancing member experience has become a critical focus for employers and benefit providers alike. Poor experiences with traditional insurance often lead to low satisfaction rates and negative perceptions among employees regarding their employers. Innovative navigation vendors increasingly offer personalized support, assisting members in managing complex health issues, which ultimately leads to improved outcomes and satisfaction. By investing in technologies and services that prioritize user experience, employers can foster a more informed and engaged workforce, significantly impacting employee health and productivity.
This episode features an interview with Michael Menerey, Senior Vice President of Alliant Insurance Services. He currently oversees and manages the Los Angeles employee benefits team and is focused on new business development and recruiting and developing talented team members. Michael has been with Alliant for over 20 years in various roles such as Vice President and Benefits Consultant. In 2021, he was named by Risk & Insurance Magazine as a 2021 Power Broker® Award Recipient for Employee Benefits.
In this episode, Sasha sits down with Michael to discuss the broken aspects of the traditional healthcare system, the lack of price transparency and quality metrics in healthcare services, and the necessity of tailored communication strategies for different workforce demographics.
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“When you're fully insured, there's just not a lot of levers that can be pulled from a cost containment standpoint. Once you move into that self-funded world, there is just a whole universe of different levers and tools at your disposal that can not only control cost, but can also improve the quality of care for employees and improve the member experience, relative to what it is in a traditional insurance model or even the traditional healthcare system.” – Michael Menerey
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Episode Timestamps:
*(01:19): Michael’s career journey
*(02:54): Why healthcare is broken
*(11:49): The benefits of self-funded health plans
*(20:18): Three point solutions that every employer should consider
*(24:36): How workforce demographics impact benefit plans and communications
*(35:23): Michael’s advice for how to manage your day