Bending The Healthcare Trend With Mark Gaunya
Health is definitely our wealth. But with overshooting inflation and soaring costs, even access to the most basic healthcare proves to be a massive hurdle. We subscribe to traditional health insurance without knowing it perpetuates the system that robs us of our choice. And the key to responsible healthcare spending lies in our hands. Employers and employees alike have the power to bend the healthcare trend and turn the situation around.
In this episode, expert employee benefits advisor Mark Gaunya joins us to talk about bending the healthcare trend for employers. He explains the real value of benefits packages for employees and how it retains and attracts talents. He then lays down what the foundation of benefits and insurance plans should look like. Mark paints us a picture of how organizations can take control of their insurance money instead of relying on premiums.
Tune in to the episode to know how to start bending the healthcare and insurance trend in the workplace!
🔥Three reasons why you should listen to the full episode:
- Learn the immense value of benefits packages in the workplace.
- Understand what the foundation employee benefits and insurance plan should be.
- Discover how employers and organizations can take control of their insurance money.
📘Resources
🎧Episode Highlights
[1:35] Working in the Healthcare Insurance Space
- Mark works in the insurance space, but he’s not an insurance broker.
- His business partner, Jennifer Borislow, founded Borislow Insurance in 1982. They have grown the company together.
- Borislow Insurance partners with employers with 50+ employees to help them with their healthcare and benefits programs.
- Mark’s passion is in healthcare. His parents were both entrepreneurial clinicians.
- He has lived on all three sides of the equation. He worked at his parents' physical therapy management company, insurance carriers, and the consumer side.
Mark: "No margin, no mission. It needs EBITDA if you're for-profit —— and less EBITDA means unhappy shareholders.”
[5:20] The Value of Employee Benefits Package
- The benefits package is the second largest line item next to payroll.
- Studies have shown that employees care more about the benefits package than their paycheck.
- A correctly-designed benefits package helps employers retain and attract talents.
- What they do at Borislow Insurance is to build on top of an organization's already special culture.
[6:17] The Risk and Cost Quadrant
- Imagine risk and cost as four quadrants in a box.
- The lower left end is low risk, low cost. The upper left end is low risk, high cost.
- The lower right end is a high-risk, low cost. The upper right end is a high-risk, high cost.
- The people who feel fine in the lower right often go up to the upper right end.
- Less than half the people Mark and his team work with have a relationship with a primary care physician.
Mark: “Today's behavior causes tomorrow's claims, which then causes the future premium that you have to pay through your paycheck.”
[12:08] What the Foundation of an Employee Benefits Plan Should Be
- Employers should be aware of their employees’ healthcare problems.
- The foundation of a workplace’s employee benefits plan should focus on the people they’re insuring.
- There must be a strong linkage between people’s health and their wealth.
- Captivated Health is a community of like-minded school employers that individually takes control of their healthcare future while collectively sharing risk.
[13:42] The Four Principles of Captivated Health
- The community’s first principle is an unrelenting focus on the members by ensuring everyone has a primary care physician relationship.
- The second principle is consumerism and helping people understand and access the language of healthcare.
- The third principle is developing an understanding of the inverse correlation in insurance.
- The five elements critical to building a culture of health and well-being are physical, financial, workplace, community, and mind and spirit.
- The fourth principle is governance. They built a structure where everyone has an equal say in what happens in the community.
[18:29] On Health Insurance Companies
- Captivated Health has helped organizations put away $25 million in their collective bank accounts instead of an insurance company.
- The construct of health insurance companies doesn't often serve the people they need to help.
[20:53] Taking Control of Your Insurance Money
- Most organizations buy insurance by transferring all the responsibility to the insurance carrier.
- The reality is they’re transferring away 60 to 70% of the risk they should be taking on themselves.
- Relying on an insurance broker’s convenience gets you a “less bad renewal” every year that’s unsustainable in the long run.
- Taking control means having self-insurance and using reinsurance to protect the organization’s limit of liability.
- It's about having an awareness of the risks and knowing how to help employees access critical consumer areas.
[22:13] A Close Look at the Price Variation in Healthcare
- Knowing the variation in price in healthcare facilities and medication can save money.
- Many medications sold in the US originate from tier-one English-speaking countries. The price shoots up seven to eight times once they reach the drugstores.
- Instead, organizations could look into direct, clinically-coordinated medication importing for employees' needs.
Mark: "There's this price variation in healthcare. The unit cost is the evildoer of the rise in healthcare costs."
- The tenfold variation in healthcare price results from a contract negotiation we’re not aware of.
[27:27] Bending the Healthcare Trend for Employers
- Mark's team is passionate about making healthcare and benefits easier and more affordable for employers.
- They wrote the book Bend the Healthcare Trend to help employers build a culture of consumerism, health, and well-being.
- There would be a bad claim once every five or six years. But there would only be minimal challenges every other year.
- Constant renewal and switching of ever-rising insurance premiums is not a financially responsible strategy.
- Becoming your own insurance company and working with a firm like Borislow Insurance can help you take control.
🧑💼About Mark
Mark Gaunya is a principal at Borislow Insurance and the founding principal and CEO of Captivated Health. Borislow Insurance is a leading regional employee benefits brokerage offering high-quality care for employers and individuals. Meanwhile, Captivated Health provides innovative solutions to help middle-market employers bend the healthcare trend.
Mark is an employee benefits advisor with over 30 years of experience and expertise. He is a pioneer in Consumer-Driven Health and Wellness Plans (CDHP) that aims to improve well-being while lowering healthcare costs. Marks is also a Member of the Board of Directors at the Massachusetts Health Connector and the National Legislative Chair at the National Association of Health Underwriters (NAHU).
If you want to reach out to Mark, you can contact him through his email or LinkedIn.
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