By MATT McCORD
American manufacturing is making a comeback. Pushed by tariffs, provide chain instability, and shifting financial priorities, firms are reshoring manufacturing—reinvesting in U.S. labor and operations.
However there’s one main impediment nonetheless standing in the way in which: the crushing value of American healthcare.
For many years, U.S. employers have overpaid for healthcare with out enhancing outcomes. Ballooning insurance coverage premiums bloated administrative prices, and an opaque, middleman-driven system have left companies with the very best healthcare prices on this planet—twice as a lot as prime world rivals.
If manufacturing is returning, shouldn’t we be demanding a extra environment friendly and productive healthcare mannequin to assist it? The identical industries that when offshored to flee labor prices should now confront the truth that the previous manner of shopping for healthcare is damaged.
The Consolidated Appropriations Act (CAA) & The Rising Fiduciary Danger
The sport has modified. The Consolidated Appropriations Act (CAA) of 2021 imposes strict new fiduciary necessities on employers that sponsor well being plans. Firms can not blindly belief huge insurance coverage carriers or PBMs to behave of their greatest curiosity.
If companies fail to correctly handle their healthcare spend, they’re now accountable for extreme prices, lack of transparency, and conflicts of curiosity.
🔴 This isn’t simply theoretical—JP Morgan Chase is now dealing with a class-action lawsuit over the way it managed its worker well being plan, with board members named as defendants.
Employers have all the time scrutinized workplace provide prices, journey budgets, and vendor contracts—but they’ve handed over healthcare procurement to third-party insurers with zero accountability.
Now, that lack of oversight is a authorized danger.
Why Employers Want a Chief Well being & Advantages Officer (CHBO)
Each main enterprise perform has an govt chief guaranteeing technique, effectivity, and accountability:
- CFOs handle monetary well being with precision.
- COOs streamline operations for max productiveness.
- CIOs leverage expertise to drive innovation.
So why will we proceed to let third-party insurers and middlemen dictate healthcare buying with no devoted govt overseeing the technique?
Mark Cuban lately known as for a brand new C-suite function: the Healthcare CEO (HCEO). A extra applicable and fewer complicated time period often is the Chief Well being & Advantages Officer (CHBO). This chief would act as a fiduciary to the corporate, guaranteeing that its well being advantages technique delivers higher outcomes at decrease prices—similar to a CFO does with monetary oversight.
This isn’t a job for HR.
Most CHROs are already managing compensation, expertise technique, DEI, workforce improvement, compliance, and extra. Anticipating HR to additionally grasp advanced healthcare contracting, negotiate with PBMs, and implement fiduciary accountability is unrealistic and unfair.
A Chief Well being & Advantages Officer would guarantee:
✔ Strolling away from wasteful business incumbents (huge insurance coverage carriers, opaque PBMs, overpriced hospital networks).
✔ Constructing customized well being profit plans with direct contracts and value-based care.
✔ Utilizing a pass-through PBM to make sure drug pricing transparency and decrease prices.
✔ Eliminating middlemen that add value with out enhancing care.
✔ Negotiating like a CFO—treating healthcare as a enterprise expense, not a sunk value.
The Flawed Strategy: Price Shifting is Not a Resolution
For years, companies have responded to rising healthcare prices by pushing the monetary burden onto staff—greater deductibles, elevated out-of-pocket bills, and restrictive networks.
However a workforce buried in medical debt, avoiding care, or battling persistent situations with out therapy will not be a productive workforce. As a substitute of asking,
❌ “How rather more can we make staff pay?”
we must be asking,
✅ “How a lot can we save by buying healthcare smarter?”
A Fiduciary Strategy to Healthcare Buying
Simply as a CFO would by no means let an organization overpay for uncooked supplies, a CHBO would by no means let an organization overpay for healthcare.
This implies adopting fashionable, fiduciary-driven healthcare procurement methods equivalent to:
✔ Clear pricing and direct contracting with high-quality suppliers.
✔ Go-through PBMs that get rid of unfold pricing and rebate traps.
✔ Superior major care and on-site clinics that cut back hospitalizations and ER visits.
✔ Customizable well being plans that match the corporate’s workforce wants—not a one-size-fits-all insurance coverage service plan.
The most effective firms don’t tolerate inefficiency in another main expense, so why ought to healthcare be any completely different?
Name to Motion: It’s Time for Daring Motion
The authorized dangers of ignoring healthcare procurement have by no means been greater.
Firms that embrace CHBO management and fiduciary-driven healthcare buying will acquire an enormous aggressive benefit. They’ll spend much less on waste, present higher advantages, and entice prime expertise.
The businesses that stick to the established order? They’ll proceed overpaying, dealing with lawsuits, and scuffling with rising prices.
Manufacturing is returning to America. However with out fixing the damaged healthcare system, we danger driving it away once more.
It’s time for daring management. It’s time for the CHBO.
Matt McCord, MD is an anesthesiologist and founding father of Opioid Free Solutions and Benesan.org, serving to employers handle overprescribing whereas modernizing well being advantages buying
