Academy of Management

By Daniel Butcher

In the aftermath of the killing of UnitedHealthcare CEO Brian Thompson and the arrest of suspect Luigi Mangione in December 2024, it’s crystal clear that many people are deeply dissatisfied with the U.S. health insurance industry. With no realistic hope for legislative reform on the horizon, though, the onus is on employers to ease the administrative burden on employees and go to bat for them when health insurers or third-party administrators (TPAs) deny coverage of their doctor-recommended procedures, medications, and other medical services.

Academy of Management Scholar Tim Pollock of the University of Tennessee, Knoxville said that whenever he’s spoken to people who work in human resources (HR) about this issue, they often say that they don’t have sufficient staff members to handle benefits-administration oversight. In that case, it’s up to C-suite executives to come up with a solution for proper oversight of insurers and TPAs.

“HR people often say that’s the responsibility of the insurance companies, and many organizations outsource benefits administration,” Pollock said.

“Part of what they should be doing, though, is tracking this stuff and saying, ‘Okay, are we getting what we’re paying for?’ because things like health-insurance costs and benefits are hugely important to their employees, but they’re treated as a fringe benefit by the company,” he said.

“It isn’t a primary focus for CEOs—they don’t consider it to be part of what they need to be doing, but that would be a great thing for them to do.”

A coordinated effort to prioritize oversight of health insurance and benefits administration among senior executives at U.S. companies could help employees’ well-being and healthcare outcomes.

“Even a Walmart or some other company that employs millions of people, they’re one company in the face of a huge [healthcare] industry, but if you had a bunch of CEOs of big companies band together and say, ‘This is not adequate. This is not sufficient. We aren’t happy with the services that we’re being provided,’ and they make it public, that could bring about change,” Pollock said.

“Going public has to be a big part of it; that’s going to help bring pressure to bear on health insurers and TPAs, because one of the challenges they face is the U.S. insurance company playbook as well, which says, ‘Okay, fine, then go work with somebody else,’” he said.

“But they’re all doing the same stuff, so employers don’t really have an alternative, and it’s to the extent that either somebody can come along and provide a different kind of service, which is going to be very hard, or employers are going to have to try to find ways to put pressure on insurers and TPAs collectively, publicly, building on the emotional reaction that people in the U.S. have had to high healthcare costs, administrative burdens, and frequent denials of medical services.”

Author

  • Daniel Butcher is a writer and the Managing Editor of AOM Today at the Academy of Management (AOM). Previously, he was a writer and the Finance Editor for Strategic Finance magazine and Management Accounting Quarterly, a scholarly journal, at the Institute of Management Accountants (IMA). Prior to that, he worked as a writer/editor at The Financial Times, including daily FT sister publications Ignites and FundFire, Crain Communications’s InvestmentNews and Crain’s Wealth, eFinancialCareers, and Arizent’s Financial Planning, Re:Invent|Wealth, On Wall Street, Bank Investment Consultant, and Money Management Executive. He earned his bachelor’s degree from the University of Colorado Boulder and his master’s degree from New York University. You can reach him at dbutcher@aom.org or via LinkedIn.

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