For episode seven of our podcast, we were joined by Carl Schuessler, co-founder and managing principal of Mitigate Partners. Carl has more than 30 years of experience in benefits consulting and financial services, and even pioneered the fiduciary approach to benefits advisory services. So obviously, we walked away from this episode with a lot of new knowledge and hope you will too!

Our hosts for this episode, Steven Cutbirth and Doug Bain, discussed several topics with Carl, including how to achieve best-in-class benefits without spending a fortune, how better benefits can lead to improved clinical and financial outcomes for health plans and their members, price transparency, direct primary care, and so much more.

You can listen to the whole episode here or on Spotify, Apple Podcasts, or wherever else you listen to podcasts. If you’re short on time, we’ve included a few highlights from our conversation below:‍

Steven: “I saw that the Time Magazine article, America’s Bitter Pill by Steven Brill, which was later turned into a book that I thoroughly enjoyed, is what inspired your idea to create the FairCo$t Health Plan. Can you share more about your inspiration and give an overview of The FairCo$t Health Plan?”‍

Carl: “Every year we had to deliver bad news to clients and we'd get a raise. They would make their benefits worse and their employees would take a salary decrease because they had to pay more out of their pocket. And that wasn't getting it done. And so I said to myself, ‘Well, I can not work with these people.’ Then I was able to start looking at independent third-party administrators and learn real quickly...it's very difficult to find a good TPA. It really is. But when you're digging in the weeds like we are and you’re as thorough as we are, and then we build these benefits champions at our clients, you learn things you don't know. So I'd go to TPAs and I would say, as an example, ‘Hey look, Doug, I'm having a party. I've got the booze locked down. I got catering locked down. I've got the valet parking and I got the band. Only problem is I ain't got nowhere to have my party.’ And they say, ‘Sure Carl we'd love to. You know, we think highly of Steven and we're glad you called us and thanks for calling. But Carl, you can't serve bud light. You gotta serve Michelob light.’ And I’d say ‘No I want to serve bud light.’ And they wouldn't let me. And I said, ‘Well, that pretty much ends this conversation.’ What I figured out is I'm not going to rely on anyone. Our job is to be a fiduciary and a steward of our client's money; treating it like it's ours. That is our job. That's what they're hiring us for. That's the way I feel. So why am I going to allow some other person to do that? And a lot of the TPAs, again there’s really good ones out there, but a lot of them have their own solutions from a cost containment standpoint, and they generally get paid on some of them, which is fine, as long as that's transparent. So we built a model where we bring the party to them, the Fair Co$t Health Plan, and they administer it and they get paid a per-employee per-month admin. And that's really how that whole thing started.”‍

Doug: “So tell us your thoughts about price transparency. You're obviously deploying resources to help people shop through it. How do we make it more shoppable? How do we make it more subject to the kind of economic forces that could help bring some costs down?‍

Carl: “The problem is, you've got to get the employees to care... Everybody talks about consumer driven plans and I do want the employees to have a skin in the game, but I'm telling you that high deductible plans haven’t worked because people are scared to use them. We see it all the time and utilization is terrible but people say ‘Oh, we're saving a lot of money!’ Wait, three years, see how that works out for you. So I think you gotta be able to do that and build it where they go, where you want them to go, but more importantly, they go where they should go. And that really is done by the cost and quality, and the transparency.”

To hear the whole conversation, click here for the full podcast episode. You can also hear more from Carl by visiting Mitigate Partners’ website and following them on Twitter and LinkedIn.