Donovan Pyle
@DonovanPyle
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Health Insurance Whistleblower & Author of “Fixing Healthcare: How Executives Can Save Their People, Their Business, and the Economy” — coming in NOVEMBER
Orlando, FL
Joined August 2009
Do CFOs have any idea how much their benefits broker’s conflict of interest is costing them? Healthcare is the fastest growing financial risk on most P&Ls. It’s usually a top-three expense. Most of the people who file bankruptcy due to medical bills have health insurance.
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For Health Compass Consulting's 7th anniversary, we decided it was time to freshen things up a bit. Our new brand colors signify our commitment to protecting mid-size employers from waste, fraud, and abuse, while improving coverage and care for employees. Did you know that
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Starbucks spends more on healthcare than coffee, and they overpay for healthcare by ~$4,000 per employee per year. AI isn't going to fix that.
Huh? Starbucks is a retail sugar company. If he is serious, here is what it would mean to be “all in on AI”: A) all drinks made by robots by 2030 (Optimus or Figure) B) deprecating legacy Software Industrial Complex licenses (SBUX is probably paying billions per year in
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Health insurers are wholesale distribution partners for hospitals and drug makers. Legacy brokers serve as retail distribution. This is why all 3 make more money when costs go up — not down. This is why employers who rely on brokers for financial advice overpay for healthcare
We will be publishing our deep dive into the Business Model of Healthcare at the end of this month, covering everything from the basics of payers, providers and patients, to key trends like value-based care and vertical integration that are reshaping incentives. As always, we
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Health insurers are wholesale distribution partners for hospitals and drug makers. Legacy brokers serve as retail distribution. This is why all 3 make more money when costs go up — not down. This is why employers who rely on brokers for financial advice overpay for healthcare
Providing high quality and affordable healthcare is one of today's most critical challenges. This week we launched four SPACs to support the ambitious work being done by biotech companies in neurology, immunology, oncology and organs. We call this Bio 2.0. Full memo attached.
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“If hospitals lose money on Medicare, why do they take it?” - William Rusteberg This is a really important question that levels the narrative that hospitals have to charge employers 3X what Medicare pays them “because they lose money on Medicare”. Comprehensive studies by RAND
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In my new book, Fixing Healthcare, I expose how misaligned incentives are costing American businesses $325 billion in unnecessary healthcare spending. And more importantly, I provide a 6-step process executives can use to reclaim that lost profit. Washington DC will not save
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A critical selection criterion for your benefits advisor is total independence. They cannot have financial allegiances or back-end deals with insurance carriers. Contractually, their loyalty must be exclusively to you, the project owner. Anything less is an unacceptable
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A critical selection criterion for your benefits advisor is total independence. They cannot have financial allegiances or back-end deals with insurance carriers. Contractually, their loyalty must be exclusively to you, the project owner. Anything less is an unacceptable
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How do insurers manage medical loss ratios to comply with the ACA? —Increase medical spending. Of course, premiums keep rising.
"MLR is another reason the ACA became the unaffordable care act." "Since the insurance carriers helped write the ACA, maybe those consequences weren't so unintended." "Only one not making money on the deal and still getting sicker, the American people."
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Health insurers are wholesale distribution partners for hospitals and drug makers. Legacy brokers serve as retail distribution. This is why all 3 make more money when costs go up — not down.
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A critical part of onboarding is the blueprint handover—the secure transfer of all your plan data. A broker files this away until renewal. A fiduciary advisor begins analyzing it on day one, immediately identifying compliance gaps, waste, and opportunities for cost savings.
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Cultivating a fiduciary mindset means changing the questions you ask. Instead of "How can we lower the renewal increase?" you should be asking, "Can I prove that our plan is operating efficiently and solely in the best interest of our employees?" It’s a strategic shift from
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The ACA was written by insurers — for insurers.
"MLR is another reason the ACA became the unaffordable care act." "Since the insurance carriers helped write the ACA, maybe those consequences weren't so unintended." "Only one not making money on the deal and still getting sicker, the American people."
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Coming November 12th. I expose how misaligned incentives are costing American businesses $325 billion in unnecessary healthcare spending. And more importantly, I provide a 6-step executives can use to reclaim that lost profit. Washington DC will not save you. You have the
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Trump makes the case for limited government almost daily. The left could use this to their advantage, but they’d have to stop loving government.
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"Healthcare is insignificant...benefits are just along for the ride." This what legacy brokers say every time I remind them that the worse job they do for employers, the more money they make. It's not their fault. The brokerage industry was developed to serve as retail
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For too long, CFOs have managed benefits defensively, trying only to brace for the impact of the next renewal. My vision is for you to go on offense. It's time to turn your benefits program into a strategic asset that actively drives down your overhead, attracts the best
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Real healthcare reform will not be handed down from Washington; it will be driven by business leaders in boardrooms across the country.
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