Tackling Big Drivers of Unnecessary Healthcare Cost

At The Alliance’s 2025 Spring Symposium, Brian Klepper, Ph.D. External Link. Opens in new window., delivered a powerful keynote that tackled one of the most critical issues facing American businesses and workers today: the relentless and unsustainable rise of healthcare costs. Drawing from decades of expertise, Klepper outlined not only the systemic failures plaguing the U.S. healthcare system but also actionable strategies to drive change. 

Keep reading to get the most important insights from Brian’s presentation. You can also watch the most popular presentations from the 2025 Spring Symposium on The Alliance’s YouTube channel.. External Link. Opens in new window. 

A Healthcare System in Crisis

Klepper explained that American healthcare has lost its way, and the consequences have been devastating. Healthcare inflation has risen 3.7 times faster than general inflation since 1952,. External Link. Opens in new window. and more than 40% of Americans now carry healthcare debt, with 12% owing more than $10,000.. External Link. Opens in new window. Even those with insurance are not immune — over half of Americans with hospital debt have health coverage. External Link. Opens in new window., and two-thirds of personal bankruptcies are linked to medical expenses.. External Link. Opens in new window. 

The cumulative impact has been catastrophic for many Americans. Klepper stated, “healthcare has stolen the American dream.” Wage increases have been dwarfed by rising healthcare costs, leaving less disposable income for essentials like housing and food. In stark comparison with other advanced nations, U.S. healthcare consistently delivers lower value, despite its high costs.  

The Need for a Paradigm Shift

Klepper challenged attendees to ask tough questions: Can we truly reform healthcare in America? His answer was a cautious but hopeful yes — if all players in the healthcare ecosystem are willing to rethink their roles and demand a new approach. 

Given the healthcare industry’s immense financial and political power, practical reform requires more than good intentions; it requires strategic action. Klepper emphasized the need for resource investment, innovative thinking, and a deep understanding of the transactional dynamics that define the cost associated with healthcare system today. 

Five Pillars of Transformative Change in Healthcare

To achieve better patient outcomes at lower costs, Klepper identified five critical areas of focus to reform the healthcare industry: 

	Accessible Healthcare Analytics to Support Decision-Making:  Employers must demand easy-to-use, up to date analytics dashboards. These tools should clearly display key performance indicators and quality metrics for each provider and show transparent pricing by procedure for providers in a region. Employers should also be able to see analytics for their employee population to identify strengths and weaknesses in the population and the per-employee-per-month (PEPM) cost of each health plan’s program elements.   The Alliance empowers employers with analytics that provide data-driven insights. Our Smarter HealthSM analysis is a customized healthcare analytics report that provides the foundation for a successful employee steering program. Using these analytics, employers gain transparent access to their claims data, providing deep visibility into the categories where their  dollars are being spent — and where they can save — without compromising the quality of care.
	Mobilizing Purchasers’ Collective Power:  Historically, employers have operated as fragmented healthcare purchasers, acting independently instead of as a united group. This dilutes their market leverage and hinders their ability to lower costs and drive change.   A critical mass of self-funded healthcare purchasers needs to become sufficiently frustrated with the current healthcare system that they become willing to leave legacy healthcare models for proven high-value approaches. Klepper called for the formation of strong healthcare purchasing coalitions that can drive demand for high-value healthcare solutions that are aligned with employers’ and employees’ interests.  The Alliance understands that to influence change, we need to work together. The cooperative is involved with organizations the National Cooperative of Healthcare Purchaser Coalitions. External Link. Opens in new window., The American Benefits Council. External Link. Opens in new window., The Self-Insurance Institute of America, Inc. (SIIA). External Link. Opens in new window., Wisconsin Manufacturers & Commerce (WMC). External Link. Opens in new window., Advancing Free Market Healthcare. External Link. Opens in new window. and our employer-members to increase our reach.
	Empowered Advanced Primary Care (APC) Clinics: At the heart of Klepper’s strategy is a revitalized primary care model, including worksite-based clinics that manage preventive care, chronic conditions, and complex medical needs. Klepper predicted a well-run APC model can yield a three to one or greater return on investment for employers. Learn more about the benefits of Advanced Primary Care here.
	High-Performing Specialty Solutions: Specialized vendors that consistently deliver positive outcomes at lower costs, especially in areas like cardiometabolic management, complex disease care, and pharmacogenetic profiling, must be vetted rigorously. Klepper outlined key questions employers should ask, including proof of longitudinal results and financial sustainability.
	Integrated Risk Management Platforms: Finally, instead of relying on disparate solutions, Klepper advocated for bundled platforms that simplify administration, improve patient outcomes, and aggregate savings across the healthcare ecosystem.

Real-World Solutions and Success Stories

Klepper illustrated these ideas with examples of strategies that can achieve impressive results: 

Optimized Chronic Care:

Training clinicians in Optimal Medical Therapy (OMT) and equipping them with AI-powered tools can significantly improve chronic disease outcomes. This can save approximately $5,000 per patient each year and achieve a 5:1 return on investment.

Whole-Person Primary Care:

Inspired by innovative care models, holistic primary care delivers personalized, relationship-based care. This type of care can greatly reduce total costs, including emergency room visits, and hospitalizations compared to traditional models.

High-Impact Specialty Management:

Designed for complex conditions like cancer and neurological diseases, this strategy targets small, high-cost patient populations with tailored interventions that substantially reduce spending.

Precision Medication Management:

By using pharmacogenetics to guide prescribing decisions, precision medication management helps clinicians avoid ineffective or harmful drug reactions. This offers the potential to save an estimated $171 million annually if implemented at scale.

Demanding Excellence in Healthcare

A recurring theme throughout Klepper’s presentation was the importance of rigorous validation. Many vendors designate themselves as “high performing” without the data to back it up. Employers must demand evidence, testimonials, long-term outcome data, and, where possible, financial performance guarantees. Only through this vetting can true high-value healthcare be identified and scaled. 

The Final Takeaway: Action Starts Now

Klepper closed by stating that the healthcare cost crisis is not inevitable. Employers hold the key to change — but only if they are willing to step outside traditional models, unite with like-minded organizations, and insist on higher standards of performance and value. By working together and demanding accountability, employers have the power to bend the medical cost trend, improving care while lowering costs.  

As Klepper put it, finding better solutions isn’t about hope or luck — it’s about demanding excellence, requiring proof, and refusing to settle for the status quo. 

If you would like to help The Alliance in our mission to move healthcare forward, reach out to us. Share your ideas and let’s transform healthcare together!