Episode #111: Reclaiming the American Dream through Reframing Employer-based Healthcare, with Dave Chase


Our topic this episode may be one of the most misunderstood and challenging issues in healthcare delivery – with significant potential for lowering costs and improving outcomes. The topic is employer-based healthcare; and as many of you know, employers pay for 50% of all the healthcare costs in the US.

Escalating healthcare costs over the past few decades have imposed a major strain on corporate America and its employees. The Kaiser Family Foundation reported that in 2018, employers paid approximately $20,000 per year for healthcare for a family of four, $6000 of which the employee paid. They also reported that since 2006, employee healthcare premiums have risen twice as fast as wages.

As a result, Corporate America has been increasingly focused on right-sizing healthcare costs – from Apple and Amazon launching their own employee primary care; to Walmart providing ‘centers of excellence’ to its employees; to companies such as Comcast who have partnered with vendors to put alternative healthcare solutions in place for its employees.

But, the situation is challenging, as evidenced by the recently failed attempt of Haven, an employer-based healthcare initiative launched by JP Morgan, Berkshire Hathaway and Amazon. It’s a complex ecosystem involving employer-based HR & health benefits managers, employer benefit brokers & benefits consulting companies, insurance companies, provider groups & hospital systems, direct to employer providers, and collaboratives such as the Business Group on Health.

Our guest this week is a passionate expert who has a discerning handle on the ecosystem, the fundamental problems, and the proven solutions in employee-based healthcare.

Dave Chase founded & leads Health Rosetta, whose goal is to empower community-owned health plans. Health Rosetta has created a blueprint and platform that empowers health plans to deliver high quality, affordable care. Dave has authored a number of insightful books including The CEO’s Guide to Restoring the American Dream: How to deliver world class healthcare to your employees at half the cost. He received the Health Value Awards’ Lifetime Achievement for Health Benefits Innovation at the 2020 World Health Care Congress. Prior to this work, Dave Chase co-founded Avado which was acquired by and integrated into WebMD/Medscape.  He also founded Microsoft’s $2B, 28,000 partner healthcare ecosystem.

In this episode, we’ll cover:

  • Dave’s unique perspective on the fundamental problems in the American healthcare system.
  • What Dave describes as epidemic healthcare ‘financial toxicities’ and ‘financial comorbidities’, which is denying the American dream to the majority of employees.
  • Five major solutions that employers can leverage to reset and radically improve their employee health benefits plans.
  • Examples of employers who have saved a significant and sustained percentage of their healthcare costs while improving healthcare outcomes for their employees.

Dave makes some amazing claims in terms of dramatically lowering healthcare costs for employers and employees; and he’s got numerous examples to support those claims. There is no question that the solutions he proposes are disruptive to the status quo. But, rather than view them as disruptive, we can learn from these successful models and deploy the proven blueprints that he and his colleagues at Health Rosetta have catalogued and created.

One thing is abundantly clear.  The American healthcare system is not working for the vast majority of employed Americans. Dave’s facts and statistics are disturbing. What he reveals is that escalating healthcare costs are levying a hidden tax that is destroying the economic health and well-being of working American families. It’s a striking reframing of the problem that makes it very personal and very real. Once we understand this, one wonders why more employers aren’t adopting the tools and techniques that Dave and his colleagues at Health Rosetta outline so clearly.

Until next time, be safe and be well.
Zeev Neuwirth, MD