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Who you gonna call?

Remember the original Ghostbusters theme song? (If you do not, listen here.)

Perhaps because it’s summer and my kids are out of school, I have been thinking about summer movies like this year’s blockbuster, Top Gun: Maverick, and others from youth such as Indiana Jones and Ghostbusters.

Do I dare to say the obvious? Ghostbusters is the kind of song that easily gets stuck in your head, and let’s just say it was reverberating in my mind as I wrote this blog about the future of employer groups.

Undoubtedly, you must be wondering how I am going to connect self-funded employers, health plan sales leaders, and Ghostbusters. It’s simple. Really.

No lyric says it better than this one –

Who you gonna call?

If you’re all alone
Pick up the phone
And call

In short, if you are a health plan sales leader heading into renewal with a large, self-funded employer, don’t go in alone.

Imagine this scenario: Next month, you are meeting with the chief financial officer of a mid-size, regional employer that provides health benefits to 10,000 employees and their dependents. Let’s call the CFO Luke and the employer Signal Electronics.

You know Luke is laser-focused on the total cost of care for his employee and dependent population. He also wants to know about discounts applied, dollars returned as rebates, emergency department utilization, employee engagement and results tied to a diabetes prevention program offered to a subset of his insureds as well as the value of buy up behavioral health program.

First, let me assure you that I have been in your shoes. Prior to joining Softheon, I held strategic sales roles with Cambia, HealthSparq, Lawson Healthcare, Phytel, and Healthvision.

As the sales leader for Softheon, most days I talk with health plan leaders like yourself. A consistent theme I am hearing is employer groups, especially the largest, self-funded ones, are asking you – perhaps even demanding you – to justify your costs and prove your value.

Having worked with health plans, I know your in-house analytics team is busy. That means it can be hard for sales leaders to get the kind of reports needed to satisfy Luke. Even more challenging, some of Luke’s peers – the CFOs of large employers who favor ASOs – want health plans to seek third-party validation of their buy-up programs. They want a credible analysis and evaluation that they can use to make decisions about plans, benefits, care management programs, and more.

Working alongside our health plan partner, we measure and validate the impact of internal and vendor programs across an extensive library of Key Performance Indicators (KPIs) within the clinical, financial, and utilization domains. We craft health plan branded, editable dossiers by program and selected clients, that demonstrate the value and impact of the core and optional services you provide. Concurrently, we isolate programs that are candidates for optimization—those which offer the highest potential benefit based on the program and the health plan’s population—and provide a pathway to further accelerating the value for a health plan’s employer clients.

Even more exciting to me is the work Softheon is doing to empower health plans to answer employers’ longer-term questions such as:

  • What will it cost to provide healthcare benefits to an employee for her entire tenure at the company?
  • If we are unable to engage specific populations of employees in their health, what will the five-year cost be?
  • Knowing employees need to take time off to access preventive care, can we justify an onsite clinic?

To learn more about how we ensure you don’t have to go it alone with self-funded and ASO employers, read a recent blog by Softheon CEO Peter Everett here.

Jeff Maxwell, Executive Vice President, leads healthcare solutions strategy and market development, fosters innovation, and develops sources to add new growth opportunities. Prior to joining Softheon, Jeff held strategic sales roles with HealthSparq, Lawson Healthcare, Phytel, and Healthvision. He has over a decade of experience working with health plans, health systems, and provider organizations.

Outside of work, Jeff spends time with his wife and three kids, enjoying the outdoors and being involved in his local community. Jeff graduated from Portland State University where he earned a BS in Business Management and a second Major in Marketing.