Health Insurance and Businesses: Lessons from the Tragic Murder of United Healthcare CEO Brian Thompson
The healthcare industry has been shaken by the tragic murder of Brian Thompson, CEO of United Healthcare, the largest player in the industry. United Healthcare has been accused of profiteering off its clients through denying and delaying care, specifically through flawed AI technology to deny claims (technology with potentially 90% error rate), using confusing marketing strategies and exorbitant commissions for brokers to push bad Medicare Advantage plans on unknowing seniors that are highly lucrative for United Healthcare. United Healthcare administers the most Medicare Advantage plans, which can restrict care and complicate obtaining coverage for care for many seniors.
This event has brought attention to broader systemic issues in healthcare and how they impact businesses, employees, and the economy. Violence is not the answer for healthcare. Businesses and health insurance brokers can be instrumental in largescale healthcare reform by promoting programs that serve the community while also financially serving businesses.
This is a moment to critically examine how healthcare is managed, and how you can advocate for your people to drive better value and outcomes.
The Cost of Delayed and Denied Care, and Non-Transparency
Businesses invest heavily in employee health benefits, it is their second budget line item after salaries and wages, yet most are being shortchanged if not straight up robbed. From a human perspective, health insurance companies delay and deny necessary care for employees, forcing them to fight for coverage while jeopardizing their health and productivity. Your employees are spending hours on the phone getting the run around from insurance companies while they should be working or worse they are leaving the workforce due to disability and premature death.
These healthcare atrocities are compounded by exorbitant claim costs passed on to employers, which are often opaque and inflated – the insurance companies take much more than the clinical provider as fees when a health service (aka surgery, office visit, infusion, hospitalization) is performed. Stacie Richter discusses a real case where an employer paid $4 million on a claim where the provider was only paid $876,000 in this podcast episode.
At the same time, hospitals are allowed to price-gouge patients, charging wildly different prices for the same procedures depending on a patient’s insurance plan - or lack thereof – and no matter what, these pricing are vastly inflated from the CMS fee schedule. Non-transparent pricing models leave employers and employees in the dark, eroding trust and driving up costs for everyone involved.
This lack of transparency also compromises care quality. When patients avoid seeking care due to unclear or excessive costs, their conditions worsen, leading to higher downstream costs and preventable suffering. Preventing disease is cost-saving thus insurance companies reimburse little for it. Your employees getting sicker helps large insurance companies get wealthier.
The Business Case for Value-Based Healthcare In Diabetes
It is incumbent upon employers to take the lead on changing healthcare for the better. By turning to high-value healthcare programs like HeyHealthy, which focus on outcomes rather than volume at a transparent price, this program offers a refreshing alternative to the traditional fee-for-service model by prioritizing cost transparency, patient satisfaction, and clinical results.
HeyHealthy delivers targeted diabetes and hormonal care with an emphasis on expert-led, thorough relationship-based medicine and validated clinical outcomes. For example, its focus on continuous glucose monitoring, telemedicine, and proactive management has resulted in measurable improvements in health metrics like A1c reduction, weight loss, and overall quality of life.
From an employer perspective, this approach delivers three critical benefits:
Cost Savings: By reducing complications and hospitalizations, HeyHealthy saves businesses money on healthcare costs in the long run.
Employee Productivity: Healthy employees are happier and more productive, reducing absenteeism and improving workplace morale.
Retention and Satisfaction: Employees value access to high-quality, transparent care. Offering programs like HeyHealthy as part of a benefits package can attract and retain top talent.
A Call to Action for Brokers
The tragic loss of a leader like Brian Thompson underscores the urgency for health insurance brokers to rethink their role in the healthcare ecosystem. Your clients are looking to you not just for insurance options, but for solutions that prioritize transparency, value, and outcomes.
By championing innovative programs like HeyHealthy, you can differentiate yourself in the market while providing tangible benefits to your clients. Advocate for transparent pricing models, fight against unnecessary delays and denials, and empower employers with solutions that keep their workforce healthy and engaged.
In a system as complex and broken as healthcare, brokers have an opportunity to be agents of change. Let’s honor the lessons of this moment by prioritizing what matters most: better care, better outcomes, and better lives for the people we serve
If you’d like to learn more or continue this conversation, please get in touch.
