Have you ever wondered why your employer buys your health insurance for you? They don’t get involved in car insurance, home owners, etc. Why healthcare? To understand that, you have to go all the way back to World War II.

When the federal government froze wages during WWII, employers needed a way to compete for employees. As it turned out, benefits weren’t included in this freeze and became a great way to attract talent. And then, as often happens, inertia took over and we just kept doing it that way. For a while, that wasn’t such a big deal, but then healthcare costs began to explode. And it happened so quickly that before we realized it, companies like Starbucks were spending more on health benefits than on coffee beans.  Healthcare is now one of the top P&L items for every business in the U.S. Unfortunately, most C-suites aren’t looking at it as a strategic opportunity. Instead, they task ill-equipped benefits managers with trying to find the best “deal” and just “hope it doesn’t go up too much this year”.

Today’s guest is trying to change all of that. Chris Skisak is the Executive Director of the Houston Business Coalition on Health (HBCH). Chris and his team at HBCH are determined to make all employers aware of the strategic opportunity that health benefits represent and help them  execute on that opportunity.

What you’ll learn:

  • What is HBCH? (1:36)
  • What was the catalyst for employers coming together to try and collaborate on controlling healthcare costs and outcomes? (2:50)
  • The history of healthcare purchasing and how we’ve gotten to where we are today (6:30)
  • Do employers worry about investing in their employees’ health only to have them leave? (12:30)
  • Do employers have access to useful quality and outcomes data? Can they get their own claims? (16:30)
  • What types of employers are good candidates for this approach – that is, who is best positioned to take advantage of the strategic opportunity in health benefits purchasing? (19:00)
  • How do you get the C-suite involved? (21:00)
  • What is a Chief Health Strategy Officer and why do you think most employers need one? (21:00)
  • What is the Walmart Centers of Excellence program and how does it serve as a model for employers to make better health benefits decisions? (23:45)
  • Using collective influence and tools like Choosing Wisely and LeapFrog to drive change (30:30)
  • Tell us about some of HBCH’s current initiatives aimed at improving quality of care and saving money for employers and their staff. (35.40)
  • What’s the one thing that every employer should be doing right now? (43:00)

Of all the cost-savings and quality programs that I work on and study, the employer-centric approach is the most encouraging. Employers have a unique combination of pain, opportunity and spending power that should give them the sustained motivation to do this. They may be the only ones who can move the needle in a meaningful way in the near-term. I’m excited to see what happens in the next few years.

~ Don Lee

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About Chris Skisak

Chris became Director in August of 2014. Prior to HBCH, he was President and Founder of Corporate Health Management Solutions, an organizational health and productivity management company providing consulting and software to employers and their health management partners to demonstrate the value of an integrated health management strategy. Dr. Skisak had previously worked 25 years with Houston Fortune 50 energy companies in a variety of health management positions. He is originally from Chicago and attended the University of Illinois. He received his B.S. from the University of Houston and his M.S. and Ph.D. from the University of Texas School of Public Health.

About HBCH – Houston Business Coalition on Health

The Houston Business Coalition on Health (HBCH) is an employer-centric organization that allows for the sharing of evidence-based strategies and practices, while using its collective influence to assist employers effectively and efficiently deliver the spectrum of its health benefits investments.  Employer-centric implies that the value of healthcare and benefits delivery is viewed from the focal lens of the employer.  HBCH is able to discuss and impact employer health in a unique environment that brings together employers, health plans, hospital systems, physicians, benefits consultants and other health services providers.   All healthcare is local, so much of HBCH’s effort is oriented towards local improvement.  However, HBCH works with national organizations to assist employers achieve improvement in other cities where its employer members may have a presence.


Keynote Speaker: Elisabeth Rosenthal, author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back (which is a pretty good book – I listened on Audible and the reader was good at 1.25 speed).

Houston Business Coalition on Health on LinkedIn

Houston Business Coalition on Health on Twitter

Mentioned on the podcast

The National Alliance of Healthcare Purchaser Coalitions – HBCH is a member

NORC Study – Employer Perspectives on the Health Insurance Market: A Survey of Businesses in the United States: Research Highlights – Research shows that many employers in the United States that offer health insurance to employees are unfamiliar with objective metrics of health plan quality information, and most consider costs both to their organization and their employees as important factors when selecting plans. Chris told us that only 7% of employers consider objective measures of health when choosing a plan and that is why we need eValue8.

eValue8 – eValue8™ was created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. eValue8™ asks health plans probing questions about how they manage critical processes that control costs, reduce and eliminate waste, ensure patient safety, close gaps in care and improve health and health care.

Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care by Marty Makary – another great book to checkout (again, I did this on Audible at 1.25x). This came up in the context of how we all need help in selecting the right surgeon. Warning… this one is a bit startling.

National Diabetes Prevention Program a CDC program that Chris tells us has been shown to prevent many pre-diabetics from becoming diabetic, saving employers big money and improving the lives of their staff.


If you’re into all of this then you should be following Dave Chase. He wrote a book called
CEO’s Guide to Restoring the American Dream, is working on a movie about this called The Big Heist and founded the Health Rosetta Institute to develop and disseminate a blueprint for high-performance health benefits.

He was also a guest on our video podcast to discuss the movie project:
Replay: The #hcbiz Show! Ep. 29: The Big Heist Film Project w/ Dave Chase

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