Impact Healthcare Podcast

Tearing & Steering: The Future of Healthcare Cost Management with Josh Butler


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In this episode of Impact Healthcare, host Lester Morales welcomes Josh Butler, President of Butler Benefits and Consulting and High Plains Health Plan, to discuss the game-changing Texas House Bill 711—the "Tier and Steer Bill."

This new legislation allows self-funded employers to customize health plans and incentivize employees to choose high-quality, lower-cost providers through financial benefits like $0 deductibles and co-pays.

Josh shares how High Plains Health Plan has pioneered this approach, proving that transparent, direct contracting reduces costs while improving care quality.


What is HB 711? Texas is leading the way by legally recognizing tiered healthcare models that reward smarter healthcare choices.


How "Tier and Steer" Works: Employees pay less (or nothing) when they choose high-quality, cost-effective providers in Tier 1 networks.


The Big Insurance Companies’ Role: Why traditional carriers don’t fully adopt these models—premium equals revenue.


Direct Contracting Advantage: How negotiating with hospitals directly results in better deals, without hidden network fees.


Employer Action Steps: Start with a risk assessment, analyze your claims data, and shift to cost-effective healthcare solutions.

Bottom Line: If you’re still managing healthcare benefits the old way, you’re missing out on significant savings and better employee outcomes.


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Impact Healthcare PodcastBy Lester J. Morales

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