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Lowering Health Insurance Costs with Marc Wilson

George Grombacher July 7, 2022

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Lowering Health Insurance Costs with Marc Wilson

LifeBlood: We talked about lowering health insurance costs, the massive opportunity that not enough people know about, the problem of misaligned incentives, and how to know if your company can save money, with Marc Wilson, CEO of the Wesmarc Group, a benefits advising company. 

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Our Guests

George Grombacher

Marc Wilson

Episode Transcript

george grombacher 0:00
Come on Welcom to LifeBlood. This is George G. And the time is right. Welcome. Today’s guest struggle powerful Mark Wilson. Mark, are you ready to do this? I am. All right, let’s let’s go. Mark is the CEO of the Westmark group is benefits advising company working to positively impact the health and wealth of organizations and their employees. And he is the author of life and death decisions in the C suite. Mark, tell us a little about your personal lives more about your work and why you do what you do.

Marc Wilson 0:41
Yeah, I’m based in Scottsdale, Arizona, got my wife and we have a three year old and we have three for babies. So living life and having a good time.

george grombacher 0:55
I like it perfect. The fur babies get along with the real baby. Okay, Mark.

Marc Wilson 0:59
Yeah, yep. Yep. He’s, he’s, he’s just turned three last month. So he’s, he’s terrorizing them. But they’re getting along as best they can.

george grombacher 1:08
Right. Right. I like it. And in terms of the benefits, advising, tell us why it is that you’re doing that.

Marc Wilson 1:18
Really, I started out in the industry, I, as I was starting out in the industry, I was selling health plans and talking to employers, and it just really, always made me feel bad, where I when I went to an employer and and all I did was bring doom and gloom, basically to them. They essentially every time they saw me at renewal time, it was a, an increase. And, you know, how can we get a less increase, but at the end of the day, the majority of times it was it was always an increase. So I was a bearer of bad news all the time? And how can I? How could I come into a situation and get a win win for both the employer and their employees? And for me, so it’s a win win win? I guess. So. I looked at that and said, How can I do that, and, you know, with technology, and as is the Affordable Care Act, came into place and whatnot, it really disrupted the whole industry. And it was right, primed to be disrupted. And now there’s a lot of tools and ways that you can help reduce reduce healthcare costs for your employers, while still giving an excellent benefit in probably giving a better benefit than than they’ve had before.

george grombacher 2:36
Nice in terms of like a literacy level from the folks who are making the benefit decisions? Where where is everybody at? Is it just gradually people are realizing that? Or is there still a vast majority that has no idea that these changes took place? And there’s opportunities to do what you just described?

Marc Wilson 2:58
Realistically, I think it’s it’s more of, of of the latter, where these things have just recently came about within the last four or five years. And not a lot of employers are understanding that not a lot of consultants out there are actually understanding or utilizing it. There’s a lot of buzz and and buzzwords and whatnot, going around the industry, but who’s actually implementing it? And how can it be implemented in in a way that’s make sense for the employer and really aligns their health plan with their their purpose and their people? And that’s, that’s really a key place. How can we do that? In the best effective way, in most employers, it just really depends upon where they’re at, on their journey to this. It can be that they’ve, they’re very knowledgeable. And we can we can put an approach where we can really have them sprinting out the starting gate, but but a lot of times, employers are more at the crawl, walk and then run stage. So we want to make sure we meet employers where they’re at.

george grombacher 4:05
Yeah, well, I always appreciate that. All right. So walk us through maybe just just a scenario or how it works, talking about how it could be implemented that makes it a win win and everything is aligned. So what what does that really look like? Well, a lot of

Marc Wilson 4:21
times in the healthcare industry, what what had happened, it was the I was even part of this, this this, this this problem, if you will, is there’s a lot of misaligned incentives. on the provider side, the payer side, which traditionally and in larger organizations are themselves because they’re self funded. And and through the consultant side, where a lot of times we get commissions or fees based on the premiums. That’s the insurance premiums that are in the health plan. So how can we make sure that it’s aligned so that we can get the highest quality care for the best As price and make it so the employee isn’t running here to they’re pulling their hair out trying to understand how how they navigate this this healthcare system. That’s, that’s here in the United States right now. So how do we how do we do that and make sure that it’s a good outcome for them, and a good outcome for the employer. So they can they can have the best experience possible.

george grombacher 5:28
Everything you said makes a ton of sense. And it does require that people are interested in breaking sort of the norms and changing business models, because there’s probably a lot of folks who are, maybe they’re stuck in legacy systems. And I see this all over the whole financial world, if it’s, you know, financial advisory, it’s hard for companies to stop doing what they’ve been doing and make these pivots. So I totally I, I appreciate it. But I think it sounds like a better scenario, what you’ve just described. So let’s assume that that that everybody’s willing, that, that you are certainly willing, and then the organization that you’re working with says yeah, that that totally makes sense. So where do we go from there.

Marc Wilson 6:15
So what we want to do is really analyze the the population understand what the needs of the employer are, and the employees in that in that in their, their organization, what they’re needing to do. But but more importantly, it’s it’s the mindset change, it’s understanding that you can’t keep doing the same things you’re doing and get a different results, you have to look at how you can put in place and educate the employees so that they can go through this change management management process is basically what’s happening. Right now, I think that’s the biggest piece is how they transition from their old plan to their new plan. And a lot of that through leadership’s in the, in the organization having the buy in from the top, as well as communicating and keeping it top of mind, on how to use their their best employee benefits and how they can use their plan to their best advantage. And a lot of times we we build in incentives to help navigate the employee through that process and make sure that they can go to the best facilities that gives the highest quality of care, but they go to a facility that is cost effective as well. It’s it’s a little different in our industry, that that the highest higher cost doesn’t necessarily give you the best quality or outcome, if you will. So being able to do that in build designs, plant or plant designs, if you will, that’s that help employers to or employees to do that movement and make that change is really where where that comes into play.

george grombacher 8:06
Makes sense. I was just reading the other day. And I wish that I could tell you who it was that that wrote this or said it or even accurately quote, what it is that I’m about to try to quote. But he said one of the biggest bill of goods that we’ve been sold as of late probably the last 10 or 20 years is that you can get everything you want. And it’s not going to cost you anything. And everything’s going to be super easy. And that that that but that’s just BS. And what we’re talking about here is not going to be easy, it’s going to require a commitment by the employer. And understanding that, hey, you’re going to need to do work here. But over the long term, probably the short and mid and long term, it’s going to be way better.

Marc Wilson 8:50
Exactly. And and by by changing the plan, designing and building the plan design that incentivizes and rewards, certain actions by the employee makes it that win win win. So we’re able to save premium and costs for the employer anywhere from 20 to 40 percents, we’re able to build plans that give employees so if there is an issue and they utilize the preferred providers, they’re able to get a zero deductible and have all of the health care paid. So that by making the right decisions, they’re able to not only get the best quality of care, but it doesn’t hit their pocketbook. And especially now with inflation and everything happening as we go in this post pandemic society it’s we need to look at ways that can help relieve the the angst and the crunch we’re feeling it you know, at the grocery store or the gas pump or whatever those things are and healthcare is no different.

george grombacher 10:01
Yeah, for sure, I mean, the potential of saving 20 to 40%, on on health care costs for organizations, that’s gotta be super appetizing. And then just putting 50 bucks here 100 bucks there into an employee’s pocket by utilizing their health care correctly, or their health insurance rather correctly on healthcare, suppose that’s gotta be, gotta be an attractive thing to what are similar is

Marc Wilson 10:24
not only just 50 $50, or $25, it’s a pain for their deductible. So if their surgery, they had a knee surgery, and if they went to surgery, center a was 20,000, or $40,000. And if they went to the surgery center, B, it was $15,000. And you get a better outcome by going to surgery center be it saving the employer that $25,000, and they have a $3,000 deductible, it makes sense for the employer to pay that deductible. So we could be talking about a lot of money that the employees saving for that.

george grombacher 11:07
Nice, so it’s potentially way more than than I had initially thought. And so the the behaviors that will need to be shifted, it’s walk me through that, again, it’s making sure you’re going to the right providers,

Marc Wilson 11:24
going for the right providers, but also educating the employees to know that the the end all be all isn’t what the doctor just says, Okay, this is what you need to do and and you go blindly you ask questions and be inquisitive. And, you know, ask about why they’re deciding to go to this facility or why they need this treatment or, or whatnot, or, you know, what are their options there are because a lot of times it’s just knowing is half the battle, right. So knowing what you’re able to do and pushing back a little bit and not just accepting what they’re saying from a provider is always good and not just going blindly into something because the less you know about something the the more likely there is to have some type of someone taking advantage or or manipulating the system and it’s for their best interest. How do we make sure that it’s the employees in the employers best interest are in the employers best interest as we’re going into? Get our health care, because that’s where it’s coming from our employer is where the majority of us get our health care from? So

george grombacher 12:36
yeah, there’s no doubt. So organizations that that this is really succeeding for, how, how are they? What is the consistency of messaging of the education? I’m sure it’s not just at the enrollment meeting, do this from now on, and then it all works?

Marc Wilson 12:56
No, it’s definitely not, you know, making sure there is an enrollment period. And there are times to make sure that the employer or employee can talk to an enrollment counselor, or better yet, now with Zoom and whatnots, a lot of times we’re doing zoom meetings to walk them through the enrollment process. But having maybe your spouse, that’s, that’s, that’s traditionally not at those enrollment meetings, being on the phone, so that you can make the best decision and understand how the plan works and what you do. Because listen, you’re gonna go through enrollment period, here, a lot of different things. And what happens is, you’re gonna forget all of it, and you only use health care when you need it. And usually, it’s not right, during the enrollment meeting, it’s usually six to eight months later or whatnot, and you’re going What do I do? How do I do it? So so making sure that you they know where to go to get the questions and, and how to navigate the system. So a lot of times in our plans, we put together concierge or advocates, if you will, so they’re able to talk to someone and they’re able to look up in their system and figure out okay, here’s the the top three facilities and here’s, you know, some there their quality scores and whatnot, so that that way, that employee can make the informed decision instead of just going out and asking family friends going on Facebook or you know, go into a physician with a bed bedside manner, that’s awesome, but they’re their health care quality index is atrocious, and you know, you don’t want to end up doing that because then it’s going to cost the plan more and it’s going to have a lot more rework on your treatment because you didn’t get the treatment correct in the first place.

george grombacher 14:50
So sounds like this is one of those examples where technologies is are actually using it for good instead of evil. Yep,

Marc Wilson 15:00
I definitely would agree with that you leveraging technology makes makes things a lot better, but knowing that, hey, that you’re gonna have to make sure you have communication, you know, not just once a year that you have a year campaign of how do we make sure we educate, we communicate, and we utilize the plan effectively, and that goes with any benefit. Making sure that you understand how it works is you’re gonna get the most outcome of of that product.

george grombacher 15:30
Is this something that any size company can benefit from? Or is there a sweet spot?

Marc Wilson 15:35
Yeah, traditionally, you know, small to midsize employers for anywhere from 50. And over, you know, can can benefit from this, but even under 50, there are programs and, and other solutions, that they can help save costs for employers and employees. Nice.

george grombacher 15:59
And what is sort of the starting point? Somebody says, Okay, maybe, maybe this is for us.

Marc Wilson 16:07
What are they? There’s, you know, I’m part of a grassroots organization called Health Rosetta, and there’s advisors around the country so that they can go to health, Rosetta, or, you know, obviously, they can always contact me, I’m not opposed to that. Reaching out in starting that process is something that they should look at, and, you know, talk to their, their consultant, their current consultants and ask them questions about, you know, these types of things, is a good start as well. So, like, Mark, the

george grombacher 16:44
people are ready for that difference making tip we have for them?

Marc Wilson 16:48
Well, my great grandmother just passed away this week. And she was close to me. So yeah, thank you. It happened on Wednesday this week. And so I would just say that call people that you care about friend, someone or a family member that you haven’t seen in a while, just call and say hi. Tell them you love them. Because you know, time short.

george grombacher 17:16
That is well said, Man, that is. I mean, life is short. And we have such a little time even though I imagined great ground ahead and in an incredible life. So

Marc Wilson 17:30
yes, you did. But it always you know, thinking about the things that you missed, or you should have called or would have, you know, done after the fact it’s it’s always good to just you know, tell somebody you love them. Are you thinking about them so?

george grombacher 17:44
Well, I think that is great stuff that definitely gets come. Mark, thank you so much for coming on. Where Where can people get in touch with you? What is the best way

Marc Wilson 17:54
you can go to my LinkedIn I’m there. It’s It’s Mark ma RC, W Wilson, w i l s o n. Or you can go to Westmark, w e S M AR C are probably the best ways to reach me.

george grombacher 18:14
Excellent. Well, if you enjoyed as much as I did show, mark your appreciation and share today’s show with a friend who also appreciates good ideas, find mark on LinkedIn and his website. I will list all of those in the notes of the show. And you know, very, doesn’t hurt at all just to explore whether or not your company is a good fit or if it’s eligible for this kind of work and if you’re employed population is also a good fit for this kind of work, but potentially save you a ton of money. So thanks again, Mark. Thanks, George. Appreciate it. And until next time, keep fighting the good fight. We’re all in this together.

Transcribed by

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