The employer health plan conversation HR needs to rethink

Bringing your people with you 

Here is where many employers get unstuck. The plan changes. The communication does not. Fallein has watched too many companies handle it badly, drip-feeding information because they are nervous about the reaction, and getting exactly the reaction they were afraid of. 

“Employees do not like being treated like they’re stupid.” His formula is refreshingly direct: lead with the why, follow with the employee benefit, then talk through the changes. “Healthcare costs were going to go up 20% if we didn’t make a change. We had to do something different. Here’s what we’re doing. Here’s how you benefit, employee. We’re going to have a lower deductible, lower copays, lower out-of-pocket. Your premium’s staying static.” He pauses. “Now, when you talk about the changes, they’ve already heard the good stuff.” 

Transparency, he says, is not a risk to manage. It is the whole strategy. 

He offers two analogies that work well in a boardroom. A health plan, he says, should be optimized like a race car, not once a year at renewal, but continuously, fixing problems as they emerge rather than waiting for the annual tear-down, and staying with a big carrier? That is like eating at the finest steakhouse every night. “You’re gonna get a good meal and it’s gonna be predictable but it’s a premium. It’s the most expensive way to do that.” Build your own plan with the right partners, and the quality does not have to drop. “We can do just as good as Capital Grille if we have the right partners, ingredients and eat at home, but it’s always gonna be a much more efficient, cost-effective way to go down that path.” 

A final thought 

When this conversation ends, Fallein goes home to his family, picks up a golf club when life allows, fits in a workout, and by his own account just tries to be grateful. For someone who spends his days making the case that one of America’s most powerful and profitable industries needs a fundamental rethink, there is something worth pausing on there. The person most fired up about changing the system is also, apparently, the most at peace with his own corner of the world. Maybe that is not a coincidence. Maybe you have to know exactly what you are fighting for.