Original Article from BenefitsPRO.com
A decade ago, the benefits industry was sleepwalking. Fully insured plans ruled the market, the BUCA carriers called the shots, costs spiraled upward without accountability, and brokers were treated like vendors: commoditized, interchangeable, and replaceable. Then, in 2016, things started to change.
Over the past 10 years, NextGen advisers have built the highest-performing peer community in the industry, reshaped the national conversation around transparency and quality, turned consultative advising into the professional standard, and delivered a billions in employer savings.
But the greatest legacy of this first decade is not the savings, the growth, or the industry recognition. It is the hard-won lessons that emerged — lessons every advisor must embrace if they intend to stay relevant and lead in the decade ahead.
Here are 10 lessons we’ve learned from the last 10 years.
A decade ago, the benefits industry was sleepwalking. Fully insured plans ruled the market, the BUCA carriers called the shots, costs spiraled upward without accountability, and brokers were treated like vendors: commoditized, interchangeable, and replaceable. Then, in 2016, things started to change.
Over the past 10 years, NextGen advisers have built the highest-performing peer community in the industry, reshaped the national conversation around transparency and quality, turned consultative advising into the professional standard, and delivered a billions in employer savings.
But the greatest legacy of this first decade is not the savings, the growth, or the industry recognition. It is the hard-won lessons that emerged — lessons every advisor must embrace if they intend to stay relevant and lead in the decade ahead.
Here are 10 lessons we’ve learned from the last 10 years.
1. Consultative advising is the new standard
The transactional broker is becoming obsolete. Employers are beginning to recognize that a carrier-paid middleman who “manages the renewal” simply protects the status quo. A true consultative strategist uses questions, data, and business acumen to manage the health care spend, improve financial performance and advance the employer’s objectives – not the carrier’s agenda.
2. Self-funding is about control, not savings
Brokers who pitch self-funding as a “cost-savings strategy” miss the point entirely. The real value in self-funding isn’t saving money; self-funding allows employers to take control of their second- or third-largest operating expense. While self-funding isn’t sufficient on its own to manage health care costs, it is absolutely necessary for an employer to control the health care spend.
3. Elevate your conversation
Top advisers have learned to discuss EBITDA, not EOBs. They have shifted from a benefits discussion with HR to a strategic, financial conversation with the CEO or CFO. Speak the language of business to move into the C-Suite. When you tie health plan cost and outcomes to financial performance, the conversation changes. You’ll maintain an important tactical partnership with HR on plan administration, but your strategic partnership is with the executives who own the organization’s P&L statement.
4. Executives don’t buy insurance; they buy outcomes
The fully insured model sold employers on predictability and perceived safety, but delivered dysfunction and spiraling renewal increases. Executives want business outcomes — lower costs, better care, greater retention, higher productivity, healthier employees — and they’ll follow advisers who can deliver them.
5. Data alone doesn’t win business; insight does
The consultative revolution didn’t start with more data; it started when advisers learned to translate that data into meaning. Insight, not information, is the differentiator in the C-suite. As one CEO put it, “We used to get claims data, but we never got the secret decoder ring.” CEOs and CFOs will take action when they understand the story the numbers tell.
6. Transparency isn’t a talking point; it’s a strategy
Executives don’t want transparency for its own sake. They crave control over every aspect of their business, including their health care spend, which requires transparency of data. Advisers who deliver both transparency and control become indispensable.
7. “A claim is a claim is a claim”…is a lie
Health care’s big lie – “You can’t control the cost of health care” – is being debunked daily by progressive health care advisers who can implement proven cost-containment strategies in self-funded plans. Managing the health care supply chain for quality and cost is the strategy that gives advisors an unbeatable competitive edge.
8. The real cost driver is low quality
Every low-quality medical intervention triggers a cascade of downstream costs, e.g., surgical complications that require readmission, a second surgery, a longer recuperation, and more employee downtime. High quality care — from both providers and facilities — simply costs the health plan less. The best advisors become quality stewards, not insurance technicians.
9. Innovation is no longer optional
The past decade rewarded advisors who ran toward disruption, rather than away from it. The benefits status quo is fast becoming a dead end for brokers. The winners are those advisors who relentlessly seek out innovation and attend industry conferences that showcase innovative solution providers and cutting-edge strategies.
10. Communities create better advisors
The rise of the NextGen movement proved something powerful: Advisprs improve faster in a community than they do in isolation. Why? Because no one of us is as smart as all of us. Advisors have learned to reject the isolation in the old broker model and embrace collaboration. In the words of the old African proverb, “If you want to go fast, go alone; if you want to go far, go together.”
Summary
After a decade, the NextGen Benefits revolution is well underway, disrupting not just employer-sponsored health plans but also the American health care system. The brokers who embrace these lessons and join the revolution will be the winners… and will help define the future of both our industry and American health care.