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How Health Plans Work, Who Makes the Decisions, and Why Primary Care Matters
Nearly half of all Americans get their health insurance through work. But most employers don’t realize they’re running a second business: healthcare.
In this episode, Jack and Dave discuss how employer-sponsored insurance actually works—from fully funded plans to self-funded strategies—and why so many companies are bleeding cash without realizing it.
They talk about the hidden role of PBMs, the rising trend of direct primary care, and how smart employers are taking control of their costs without sacrificing quality.
Topics include:
- Why your premiums keep rising (even in a “good” year)
- How PBMs manipulate costs behind the scenes
- The difference between fully funded and self-funded plans
- Real-world examples of employers slashing spend without cutting care
- Why primary care alignment is the key lever to taking back control of your healthcare spending
This episode is for CFOs, HR leaders, or people just trying to understand their own health plan better.
Episode #02.
LINKS
The Treatment Plan on YouTube
The Treatment Plan on Apple Podcasts
Follow Dave on LinkedIn
ReforMedicine Direct Pay Primary Care
View all episodes
By ReforMediaNearly half of all Americans get their health insurance through work. But most employers don’t realize they’re running a second business: healthcare.
In this episode, Jack and Dave discuss how employer-sponsored insurance actually works—from fully funded plans to self-funded strategies—and why so many companies are bleeding cash without realizing it.
They talk about the hidden role of PBMs, the rising trend of direct primary care, and how smart employers are taking control of their costs without sacrificing quality.
Topics include:
- Why your premiums keep rising (even in a “good” year)
- How PBMs manipulate costs behind the scenes
- The difference between fully funded and self-funded plans
- Real-world examples of employers slashing spend without cutting care
- Why primary care alignment is the key lever to taking back control of your healthcare spending
This episode is for CFOs, HR leaders, or people just trying to understand their own health plan better.
Episode #02.
LINKS
The Treatment Plan on YouTube
The Treatment Plan on Apple Podcasts
Follow Dave on LinkedIn
ReforMedicine Direct Pay Primary Care