In a broken healthcare system, an adviser offers custom medical plans

After more than a decade of working for other brokerages steeped in traditional advising, Megan Cook took a risk and started her own company with the goal of doing her part to fix the “broken” healthcare system.

As one of the first 30 brokers to become a certified benefits adviser through nonprofit institution Health Rosetta, Cook is committed to exploring new ways to end the annual cycle of delivering the same annual premium increases to clients that don’t provide any cost-saving solutions.

“My goal was not to continue down the path of doing spreadsheets,” says Cook, who launched her own firm, Adept Benefits, more than three years ago.

Since founding the Bellevue, Wash., boutique brokerage, she’s been focused on moving clients into completely customized medical plans that are providing better benefits at up to a third of the cost, Cook says.

“There are so many employers out there who want to be helped,” she says.

One of the ways she is helping is by introducing them to direct contracting with hospitals and encouraging them to focus on primary care. While specialists often receive sky-high reimbursements as much as 700% above Medicare, primary care physicians are typically reimbursed at lower rates, Cook says. That gives them “a huge incentive” to send patients off to a specialist and move on to the next patient as quickly as possible.

By changing up the model with direct primary care, Cook says, employees get the service for free and are meeting with their physician for as long as 45 minutes. “You have someone who is truly assessing the person holistically, not just element by element and sending them to specialist,” she says. The result is fewer labs, x-rays and prescriptions.

Making the switch can reduce an employer’s costs in the first year by up to 20%, Cook says. This includes helping the “small pocket of employees” that make up the bulk of employers’ annual healthcare spend to find the high-quality, low-cost facilities to utilize and then incentivizing them to do so through free or heavily subsidized care at those locations.

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