Academy of Management

Why Executives Have to Take Responsibility for Healthcare

By Daniel Butcher

Many U.S. CEOs and CFOs see health insurance as a nice benefit that they subsidize for employees, but it isn’t part of their organization’s strategic plan, and they don’t see it as part of their responsibility, even though a healthier a workforce is a more productive workforce.

Academy of Management Scholar Jeffrey Pfeffer of Stanford University said that most C-suite executives delegate benefits administration to human resources (HR), which in turn delegates it to a benefits specialist or team, who, in many cases, delegates it to a benefits consultant such as Aon Hewitt and Mercer.

“It gets delegated out, and nobody is providing the oversight that they should,” Pfeffer said. “We have vendors that have hours only during working days, which means if your employees have to engage with their vendor, they have to do it during work time—I don’t think most companies are paying their employees to deal with that.

“The employers should be looking at percentage of claims denied, how much time employees are having to spend hassling with their administrators, and whether the administrators are doing a good job, just as you would look at any other vendor,” he said. “If I hire McKinsey as a consultant to provide some strategic insight, I would ask, ‘At the end of the engagement, did they do a good job? Do I know something that I didn’t know previously?’

“Employers hold vendors accountable in every domain except for this one, healthcare, which is considered to be too weird or too complex, and so employers have offloaded a lot of responsibility without any oversight, and that missing oversight is why we have the problems that we have.”

Oversight of employers should extend not only to what benefits are accepted, but also the administrative burdens on employees for getting the benefits that they pay for, especially during the process for appealing denials.

“One of the reasons why the U.S. healthcare system is so expensive, why healthcare costs so much here, even though, by any measure of performance, the U.S. does not rank in the top 20 in the world of industrialized countries in the quality of healthcare, is because of this enormous administrative burden,” Pfeffer said. “You have people who are trying to get authorization for services and others who are fighting overbilling.

“You have people who are making marketing claims to sell this stuff to people,” he said. “In the U.S. health insurance and benefits administration industries, you have all kinds of stuff, none of which adds value or provides healthcare, and this administrative burden is why healthcare costs so much in the U.S.”

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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