What does it actually look like when a health plan works?
In this episode of The Healthcare Heist Podcast, Lou Bernardi shifts the conversation from theory to results, showing what happens when companies stop accepting rising costs as “normal” and start applying the P.L.A.N. System.
For decades, employers have been told that higher healthcare spend is simply the cost of doing business. But much of that spending never improves care. It’s lost to inefficiency, hidden pricing, and misaligned incentives.
When that changes…something powerful happens.
Lou introduces the concept of the Healthcare Dividend, the dollars that were always in your plan but never made it back to your business. When waste is removed and incentives are aligned, those dollars are reclaimed and reinvested into what actually matters: your people, your culture, and your growth.
You’ll learn what winning looks like across the organization:
- Employees experience better care and lower out-of-pocket costs.
- HR leaders gain a meaningful advantage in recruiting and retention.
- Leadership regains control over one of the company’s largest expenses.
And here’s the key insight:
There’s not just one way to get there.
While partial self-insurance checks many of the boxes, it’s not the only path. Companies can begin making meaningful progress by focusing on what they can control, aligning incentives, leveraging data, and giving employees simple, effective tools to navigate care.
Because this isn’t about disruption for the sake of change.
It’s about making smarter decisions…and capturing value that’s already yours.
What You’ll Take Away…
- What a high-performing health plan actually looks like in practice.
- How the Healthcare Dividend is created, and where the money comes from.
- Why rising healthcare costs aren’t as inevitable as they seem.
- How partial self-insurance fits into a broader strategy.
- The three most important levers you can control right now.
- Why progress—not perfection, is the key to getting started.
Perfect For…
CEOs, CFOs, HR leaders, and advisors who:
- Want to see real outcomes, not just concepts.
- Are curious what’s possible with the right health plan strategy.
- Are hesitant to make changes but know the current path isn’t sustainable.
- Want to create value without unnecessary disruption.
The money isn’t gone.
It’s just been going to the wrong place.
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Listen to the podcast here
When A Healthplan Finally Works: The Healthcare Dividend Most Companies Never See
What Happens When You Apply The P.L.A.N. System And How To Get There Without Blowing Everything Up
Welcome to the show, where we pull back the curtain on one of the biggest, most misunderstood expenses in your business. I am your host, Louis Bernardi, founder of BritePath and a benefit optimization officer, certified healthcare fiduciary coach and health value advisor. If you’ve been following this series, you now understand the system and the solution. In this episode, I want to tell something different.
Defining The Healthcare Dividend: The Hidden Business Advantage
This episode is called when it finally works, the healthcare dividend most companies never see. When you think of dividend, you think of financial reward. Some sort of return on your investment. That is true, but the healthcare dividend goes much further than that and benefits every stakeholder involved in the healthcare decision making process but also, the output of your health plan to your employees and their families.
We’ve already talked about the problem, the system, the machine, the healthcare heist, the crew, and the solution. We’ve talked about the leadership alignment, the broker and the Playbook. What does it actually look like when it works? For decades, employers have been told, “Rising healthcare costs are just part of doing business.” That’s not true. A large portion of what you’re spending now isn’t improving care. It’s being lost in inefficiency, misaligned incentives, opaque pricing, hidden profits for insurance carriers and their healthcare comrades.
When that changes, everything changes. When companies apply the planned system, they don’t just reduce costs. They unlock something much more powerful. That healthcare dividend I mentioned to you. It’s the money that was always yours, but never made it back into your business. That money can be used in a plethora of different ways. It can be invested in your people, your talent, your technology, AI in and growth. That is up to you.
Measuring Success: Operational Benefits For HR And Leadership
What does it look like when the plan is working? It looks like employees getting better care at lower out-of-pocket costs, making informed decisions and feeling in control for the first time. It means HR is spending less time putting out fires, entering calls from confused employees, being forced to look at things like explanation of benefits. Asking their broker partners, “Why this particular doctor? Why wasn’t an MRI approved? It’s leadership finally seeing predictable numbers. HR has a tool, a health plan that they are proud to highlight instead of hiding from new talent.
The healthcare dividend is the money that was always yours, but never made it back into your business. Share on XA benefit plan that keeps your talent where it is, reduces retention keeps employees happy and truly says to them, “We care. We’ve put extra effort into our plan.” That’s one of the most amazing things about open enrollment these days. So often when our employer partners are implementing these new changes slightly different benefit packages, sometimes with new players. Not confusion. Only clarity. They’re excited about it. They can’t wait to talk about the contributions. The lower contributions or the lower out-of-pocket costs.
They feel proud of the work they’ve done. It was maybe a little bit more work for them. Most of that work is spending time learning and understanding. What this book is all about is trying to cut that portion of the process in half. Getting you upset, getting you to see a little bit more clearly than you do so that when a broker does call you with what sounds like crazy ideas, outside the box solutions or new strategies. You understand why they work.
You’re not starting from square one. Guarding from square one is where it gets hard. I can’t tell you how many times I’m talking to an HR leader, CEO or CFO. I’m the first one having this healthcare heist conversation with them. Talking about the crew and the machine. It sounds crazy but it’s happening right under your nose. You know it. Once you read this book, you’ll say, “I knew something was off. I knew it was too bad to be true.” It’s not true. You do not have to pay more every single year for health care for your employees.
You do not have to pay more every single year for health care. You don't have to make blind decisions or arbitrarily set budgets that aren't feasible. Share on XYou don’t have to make blind decisions. You don’t have to arbitrarily set budgets that aren’t feasible. You don’t have to accept an increase. In fact, quite often plans are seeing substantial savings, immediate savings and significant compounded savings over time. When it works, everyone wins. All the stakeholders. Employees feel it through better access, lower cost, less confusion and more take-home pay. More money that they can put into are pension plans or 401(k)s.
They can finally afford some of those other benefits that you’re now going to offer for the first time or maybe they’ve avoided in the past because the cost of the health plan was too much for them to bear such as disability insurance, life insurance or supplemental life insurance. HR feels that through better recruiting or easier recruiting. Imagine sitting across from a candidate at a talent acquisition. Your first interview with that ideal client. The person you couldn’t wait to walk through the door.
From the very first second, you slide a folder. A benefits folder across the table says, “Here’s our benefits. We’re very proud of them. We are certain that they are going to stack up against our competition in a great way. We’re not going to talk about them but I want you to take them home. If you have family to share them with, we want you to do that before we get around to talk to them.” Having that power, that tells someone immediately, “They take good care of their employees here. What else are they doing?”
What matters isn't the funding mechanism. What matters is what you do with it. Share on XBetter recruiting, higher retention, and less stress for HR. Again, you’re probably doing without technology that can help you do your job better. Maybe better payroll, admin systems, and leave of absence vendors. There’s so many things that HR needs in order to truly be efficient and get that time back. That time dividend that we talked about in an earlier episode. Leadership, CEOs, CFOs, board of directors feel in control. They have more predictability and stronger financial performance.
Taking that dividend that helps increase EBITDA and increase valuations. It makes it easier to borrow money if you’re still going to do that. Maybe you don’t need to borrow money because now you have those hundreds of thousands, if not millions of dollars that have been squandered in the past. This is not a theory. This is happening now. Again, I invite you to check out HealthRosetta.org. Look up the Rosie Award winners. We’re proud to have one.
A finalist each of the last three years and a winner a few years ago. One of the best health plans in America. A company that saved $1.2 million the first year. Not because they truly understood everything we were doing, but just knew why and how it could work. We were implementing stronger partnerships. We didn’t throw at the role plan. We just rebuilt it with better parts that worked better or more accountable and supported their employees to make smarter healthcare decisions.
Funding Strategies: Moving Beyond Premiums To Manage Claims
That $1.2 million savings that they saw in your one, which they initially thought was a fluke has happened every year since. They grow their business like their competition can’t. Here’s what I want to be clear on. There’s not just one way to do this. We’re not talking about one particular solution. We’re talking about a system. We’re talking about ultimately, at the end of the day, insurance being a way to finance the healthcare risk.
We’re talking about implementing solutions that help lower your claim spend, so that your cost of ensuring your employees is lower. Partial self-insurance means self-insurance with stop loss insurance or reinsurance. It checks all the boxes. It gives you control, especially of your plan document. If you’re doing it with the right partners. It gives you transparency, flexibility, and full capability to plug and play best in class solution partners that work for you. They can be interchanged that share data seamlessly through all those partners that understands how each and every one of them works.
Progress, not perfection, is what unlocks results. Share on XIt’s doing what your insurance company has been doing in the past. With the help of your broker partners or your new aligned broker partners, you’re building a health plan that works for you. Every component of the plan, but self-insurance is not the only path. What matters isn’t the funding mechanism. What matters is what you do with it. Do you align incentives with the partners you control? Maybe you’re not large enough to self-insure. Maybe your claims have been so out of control that getting stop loss insurance is difficult for you on day one.
Helping to better manage your claim spend can be accomplished with a fully insured plan at all. Maybe not embedded in the plan like it can be in so many ways with a partially self-insured plan. Maybe it has to be a supplement or a technology or AI. Some resources to provide your employees to combat against the steerage of the healthcare system so that your employees may have out-of-pocket costs that are higher for some types of service rather than others. If they use a tool, eliminate their out-of-pocket cost and if they’re going to high value providers.
Leverage data to identify and remove the waste. There’s ways of getting the data without being self-insured even though insurance companies resist sharing data with most employers. Provide employees with resources that are easy to use. You don’t tell your employees where your cost matters. You give them the tools and the resources that are on-hand when they need it that allow them to be informed consumers. Essentially, we’re talking about turning on Amazon for healthcare consumers.
Most companies are focused on one number: the premium. But the real opportunity isn't in the premium. It's in the claims. Share on XYou can see the cost and the quality. You can make decisions based on what matters to you most. Is it the quality of the doctor? Plus, the cost. Is that the cost because it’s not a commodity? It’s a test of lab work that can be done anywhere with any real differential in quality. Let’s make sure employees have those tools. If you do those three things, you’ve already ahead of most companies. It will show up in time. Some fixers are quicker than others. Swapping out a transparent fiduciary pharmacy benefit manager with an old antiquated insurance carrier owned PBM can rep rewards on day one.
That requires very little work at all with only lower prices for the same medications at the same facilities. The others are slower. Others require education. That’s up to your broker partners or vendor partners. They don’t just offer resources and expect you to implement them. They offer resources that are meaningful and useful. They stand behind it. They help you educate your employees. They give you reports to show which employees have used it or haven’t used it.
Your broker partner steps up and says, “We can help with this. We can help with the communications. We can come in quarterly. We can talk to new employees. We can tape record sessions that are designed to help employees understand not only what a solution does but why it’s important to them.” Selfishly they won’t do it unless there’s an incentive for them just like you won’t do it unless there’s an incentive for you. That’s human nature. A lot of leaders hear this and think this sounds like a big change but here’s the truth.
Don't settle for a health plan that isn't working as hard as it should for you and your team. Share on XYou don’t need to blow everything up. I’ve said this over and over again. You don’t need to change everything overnight. You need to start where you have control. Progress not perfection is what unlocks results. The reason why I wrote this book and I made it as short and simple as possible. Think of it as the back pocket guide. The dummies guide to the healthcare heist. Too often, it’s what you don’t know that prevents you from taking action.
You don’t need to know everything. You don’t need to know how your car works. You don’t need to understand the ignition, the steering, the braking system, the lights, the electronics, and the engine. It just needs to trust that it does work. You just need access to the information that’s important to you. The same thing with a computer. If you can sit down and explain to me exactly how my computer or Zoom or pretty much anything I use these days, I don’t even know what a voiceover phone system is but I’m using it. It worked pretty well, so I trust it.
Reclaiming Value: Why Fixing Healthcare Spending Matters Now
I can switch vendors but I like the one I have. I know what I’m paying. What most companies are missing? Now, most companies are focused on one number, the premium. The real opportunity isn’t in the premium. It’s in the claims. You can do very little about the premium that you’re paying. It will perpetually go up and up, unless you’re focused on the claim spend. The expected claims spend is the building block of your insurance costs. Whether you’re fully insured or self-insured.
Underwriters are looking at a population of employees and they’re saying, “What are the likely claims?” They’re adding 20% to 25% on top of that. Plus, all of the fixed costs, the retention, the profits, and broker commission. All of that stuff. If you reduce the expected claim spend, the whole thing shrinks. Until you shift your focus, you’ll keep playing the same game. The machine launched you to focus on the wrong things. Winning companies don’t focus on the wrong things.
Think about this. If you could lower cost, improve care, reduce employee stress and reinvest that money back into your business. Why wouldn’t you? If I ask that question to a room full of CEO, CFOs and HR leaders, who would raise their hand and say, “I wouldn’t do that.” Not one person. Unless they’re the class clown like my twin brother. This is about fixing what was never working in the first place. For years, the system has been taken from your business. You know that.
People applauded when the CEO of United Healthcare was shot down the streets of Manhattan. We know that the animosity towards big business insurance companies is very high but why won’t we act? Why are we waiting for someone else to fix this? I’m telling you that this is fixable. All it requires is a second look, a second opinion that you have gotten before. Not just the focus on insurance premiums. It doesn’t have to be that way. The healthcare dividend is real. The results are real. The path forward is more accessible than you’ve been led to believe.
The only question is, are you ready to start reclaiming? Thanks for tuning in. I hope you learned a thing or two. More importantly, I hope it helps you get the results you and your people deserve. If this resonated with you, I’d love to continue the conversation. No obligations. I love educating employers, elevating their health care IQ, and rewarding other brokers who are doing the right thing with your business. Until next time. Don’t settle for a health plan that isn’t working as hard as it should for you and your team.
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