self-funded-health-benefits-case-study

Brakebush Brothers Inc., headquartered in Westfield, Wis., uses self-funding to look for opportunities to lower the cost and increase the value of their employee health benefits. Many of these opportunities arise because Brakebush is willing to challenge the status quo in employee health benefits, according to Dan Ludwig, director of benefits and safety.   

The status quo for employers typically means that insurance plans own the employer’s health benefits data; providers set their own prices and increase them regularly; and patients have limited ability to judge where to go for care based on cost and quality. 

Instead, Brakebush utilized their claims data (a perk of self-funding their health benefits) to find opportunities where they could modify their health benefits plan to lower costs and promote better health outcomes. Employees and vendor partners were included in this process.     

The result of Brakebush’s collaborative efforts provided employee health care options that were more easily accessible, less costly and provided high-value specialty referrals.  

Support from The Top 

Ludwig praises open-minded executives at Brakebush for their support for changing the company’s approach to health benefit costs.  

“Employers have to get rid of the status quo,” Ludwig said. “That means employers can’t do it the way they’ve always done it. At Brakebush, we’re given the freedom to explore opportunities. We have to justify every one of these changes, but we’re given the ability to go and explore.”  

Ludwig believes that only companies who realize health care can be controlled will be able to achieve flat or lower benefit costs. Employers who are unwilling to challenge the status quo, learn about health care pricing or embrace innovative approaches are unlikely to gain the full benefits of self-funding.  

“The lack of understanding in the world of how health care is paid and what impact it has on business has really led us to this problem,” Ludwig said. “Employers have to look at health care and say, ‘We’re done with this.’  

“As employers, we control everything else that is on our budget and we hold vendors accountable for giving us high-value products and services. Why are we not holding health care to the same standards?”  

Are you an employer searching for self-funded health benefit solutions? If so, Ludwig offers the following tips for you to consider. 

Brakebush Brothers’ Top Tips for Self-Funding Results 

  1. Get ready to self-fund. Looking back, Ludwig thinks Brakebush should have had new solutions ready to introduce when self-funding started in 2014, so employees immediately noticed the difference.  
  2. Be willing to change. Employers get the best results by combining self-funding with data-driven changes in their health plan. 
  3. Develop a team of collaborators, internally and externally. Internally, create a team of employees who take responsibility for changing the health plan to focus on high-value health care. Externally, network with peers at other companies and then find vendor partners who are interested in working with you on innovative solutions. Your relationships will make a difference in what you achieve. 
  4. Make sure partners have aligned incentives. They should “win” financially when your company wins and lose when it loses.  
  5. Tell employees how self-funding makes a difference to their out-of-pocket costs. Explaining the relationship between the company’s costs and their health benefit premiums is a great place to start.  
  6. Remind employees of ways to save, again and again. Sharing information at open enrollment is critical, but employees also need reminders throughout the year. If you have an onsite clinic, make sure clinic providers know all the current options for employees to use programs such as Centers of Excellence. 
  7. Use employers’ combined power. Employers’ ability to change how they purchase health care grows when they work together.  

Read the case study on Brakebush Brothers for details about their award-winning approach to changing employer-sponsored health benefits. 

 

Learn More 

Melina Kambitsi, Ph.D.

Melina Kambitsi, Ph.D.

SVP, Business Development and Strategic Marketing at The Alliance
Dr. Melina Kambitsi joined The Alliance in 2017 and leads the team responsible for membership growth and retention of the cooperative. Dr. Kambitsi comes to The Alliance from Network Health in Milwaukee and Menasha, Wis. where she was chief sales and strategy officer. In this role, she was responsible for sales and underwriting, strategic planning, product development and risk-based contract analytics. Earlier she was senior vice president of sales at Blue Cross Blue Shield in Honolulu, Hawaii and the vice president of sales, marketing and product development at Blue Cross of Northeastern Pennsylvania.

Dr. Kambitsi received her bachelor’s in international studies and her master’s and doctorate degrees in economic geography at The Ohio State University. She speaks Greek fluently as well as four other languages (Spanish, French, Romanian and Russian).
Melina Kambitsi, Ph.D.

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