Fortune 50 Healthcare Strategies That Drive Results with Lee Lewis

Hey. Hey.

Welcome back to the Broker's Voice. This one is going to be a fun one, folks. If you don't know this guy's name, you might have been under a rock. But I'm excited for today's episode because I have the one, the only, Lee Lewis. Lee is the chief strategy officer with the Health Transformation alliance, working with some of the biggest companies in America on their health insurance strategies. And I've known Lee for quite a while, so it's been a while since I've had a chance to talk to him. So this will be a fun, fun conversation. So, Lee, welcome to the Broker's Voice, my friend.

Hey, thanks so much for having me, Andy. I appreciate it.

I can remember, dude, when you and I first met.

Yes.

Volk Bell's conference Room, Longmont, Colorado. In walks this guy I've never met before. You are the national sales director for Ameriben.

That's right.

And I just remember pretty quickly thinking, you know, this is like a brother from another mother, because you pulled out. You pulled out your notebook and you were taking notes. But then when you started using analogies and different ways of communicating what we do in this industry, I'm like, I like this guy.

But first, how the heck thinks about the world the way I think about the world? There's not very many.

We've had plenty of conversations on. On phone calls while you and I are both driving down the interstate of how we perceive the industry. And I'm sure we can get into that as well. But how did you find yourself in this health insurance industry in the first place? First place?

Yeah. I got into healthcare on accident. I started out in PNC insurance. I did really well. I was the very first employee at a company called Goosehead Insurance. Some people may have heard of it. I was employee number one. Unfortunately, I got antsy after a few years and I left. I gave up a couple percentage points of ownership. The company today, I think, is worth like 4 billion, 5 billion. That was the one that got away. And I started looking for something new.

And a friend of mine referred me over to Ameriben, who was looking for a new sales director and wanted to go with kind of in a new direction. They'd had somebody really experienced and it hadn't gone great. And I interviewed. They told me no. And I said, you're not going to say no to me. And I sort of clawed my way back in and they. They surrendered. And that's how I got that job.

And, you know, one thing I'd love for you to Share from your time at Ameriben, because I still remember, I still use this analogy today, is you, you shared with me at the time, Ameriben was a TPA who had a very specific ideal prospect and you only wanted so much business every year. And you use the analogy that you, it was like you handed out a dozen gold coins a year and once those gold coins were done, you were kind of looking for the next year's 12 gold coins to hand out that concept of exclusivity, which is kind of how you guys sold yourself. Do you think that allowed you guys to grow the way Amer Ben grew? Because I thought that was kind of genius.

I think it does. I don't know that it works for every, I don't think that it works for every.

Every service or every product for sure. Right. Like when you're starting out, you just need, you just need somebody to partner with when you are doing well and you don't have to be as.

Aggressively creative. I think that that scarcity level helps a lot. I think you say, look, I can, I have this much capacity. That means knowing yourself well.

And, and then, and then at that point you can communicate that way. Like, look, hey, I'm, I'm taking on three new clients this year. Here's the value that I'm going to get for you. If I'm not a fit, that's totally okay. But I just want to let you know and so, you know, can you let me know in the next month? It'd be really, it'd be helpful for me. Like, I don't know, I think just being genuine and honest about it. But I think that, that, that level of self restraint is hard and I think it sizzles well in the marketplace, you know, as, as a byproduct more than the intent of, of using the right self restraint. Once you're doing once, you're doing pretty okay.

Yeah, no, here's what I loved about it, man. You actually, it, it changed the way I sold after I met you. And you brought that up because let's face it, most advisors in our industry today, if they're going after midsize to larger companies, they're probably only selling five to 10 new accounts a year. And to use that as an example of, hey, we only can take so many every single year because of what we do and how we do it, I think creates that scarcity which actually leads to more sales. That's what I loved about it.

So you were at Amer Bend for a while, did extremely well, got Got, how do I, how do I say, lured away to Gallagher in Dallas. What made you, I'm curious. We have a lot of producers out there who work for like industry partners that are looking to make that jump into the advisor broker role. What made you make that jump?

So I had been at Ameriben for a while, handing out my little golden coins there and effectively I, I'd sell my quota within a few months. And then the joke was, is I would do an apology tour for like six months of the year where I would just say sorry that I couldn't help anyone else out. It was some sales guy and, and I loved the company. I was doing well. I was, I was really highly paid for, especially for that firm. I was paid extremely well and, and I had like the easiest job ever. I just sort of, I just went around and to fun cities and visited friends and spent money and that was all that I was doing. And there was no reason in the world to leave except I got bored and I couldn't handle it. And so I was like, I've got to, I got to do the next thing. And I was visiting. I was, all I did all day was visit with consultants and brokers, met with a team over at Gallagher and they were like, hey. And I was like, hey, I'm kind of thinking about, you know, maybe, maybe I can move here to Dallas. And they were like, oh really? They're like, you know, we'd like for you to come and join the office. And I'm like, look, I don't want to become a consultant because I think most of them like, you know, present company excluded, but most consultants, I don't understand the value that they're creating.

A lot of them kind of obstruct value, even the opposite of what you'd hope. And I really want to help change American healthcare. Plus, I only know large groups. I'd only ever worked with larger groups at Mariban. And so that was where my comfort level was. And.

But I said to them, look, if you're okay with me opening up like an innovation based practice that focuses on large jumbo employers, that's really weird. I don't think it's your normal, you know, your sort of baseline product or staff member, but if you're open to me creating something unique and kind of different there, we'll see. I, I think that there's a lot of appetite for that in the marketplace and huge credit to them. They said, they said, sure. Neil and Sri Tafoli, they were like, let's figure it out, make it happen. So we went entrepreneurial and it created a new kind of practice unit within us, within kind of an established consultant.

Well, and I'll tell you man, what impressed me so much is it didn't take you very long after getting there. I remember a phone conversation. In fact I came and visited you one time in Dallas.

You were, it didn't take you very long and you were meeting with Fortune 500 companies. I remember, I remember some of the names you threw out over phone conversations. I was like, damn, this guy is doing some stuff here. And when you started getting into that space, I'm curious, this might be a good piece of advice for the advisors who are listening in. What did you notice, you know, maybe from your time at Ameriben where you were working on still large sizable groups but now you're talking in some cases some of the largest companies in America, did you notice a big difference in how a Fortune 500 company views its health insurance versus maybe a mid sized 500 to a thousand life group?

Yes and no. There's some fundamentals that are the same where they're all, they're all experiencing the same pressures like the, the needs, the drives, everything. There is extremely similar with large group to small. Not all of them on either side, not all of them. But by and large there is, you know, like Exxon is a big company. They're, they don't have to think that much about health care and costs. Making cutbacks like it's not been an issue for them. You know, speaking, I don't know, I haven't talked to them recently. But generally in conversations with them they're like, look, we want to offer the, the best, most competitive, most aggressive wonderful benefits so that we can attract and retain the best talent. That was their value prop. They're not worried about spending less or they're trying to find new and better ways to offer unique and exciting benefits. Their people, great strategy and from their position that was something they could easily offer. Then you talk to a grocery store retailer.

An industrial gases firm that is, you know, has got razor thin margins, totally different conversation. So there is, there is some differences there. But if you are strapped financially, if you're a retailer that's small, just a local gas station, or a retailer that's large, like Macy's Corporation, you guys are under the same pressure. So that part is similar. The way that they approach healthcare and the tools used are very different.

There's sort of two types of solution sets. There's solution sets that are agility based and There are solution sets and strategies that are asset based. If you are big, you use asset based solutions strategy. If you're small, you use agility based strategy. And this is true not just in benefits, this is true in anything. Right? Like you know.

When Google was created, right? Why is it that they were able to, you know, they were able to come in and just destroy Netscape, right? Or ask Jeeves or Lycos or Yahoo. There were a million other search engines, right? The things that enable a small company to be just lethal is that they have, they have that really, really high agility that no large company, large companies just have to trade that out unfortunately, when they get bigger. But the nice thing though is that the big companies, they have unlimited lawyers, they have unlimited resources, they have unlimited staff, they have unlimited connections, lobbyists. Those are asset based strategies. So smaller employers can use asset based employer health benefits strategies and the large ones can use asset based. What are examples? Agility based, reference based pricing. Agility based local niche nuanced direct contracts. Agility based is local direct primary care relationships with like a local doctor or a team of doctors who own three locations and they're all like right near your facilities, right near your people. Awesome. Large employers never going to be able to contract with that, at least not traditionally. But a small employer can be all over that and can be tightly managing nuanced communications. Totally agility based. If you've got 200 people and they're like in one or two buildings in one or two towns, you can do some incredibly nuanced things with your health care. If you have 100,000 employees spread across 36 states, 1400 cities and all four time zones, freaking. You are never going to communicate something nuanced or unique or special. Local strategy is agility based. National strategy is asset based. So those are a few examples.

I like that a lot. Because, you know, one thing I think about is a name that many in our industry have talked about is the Rosen Hotel example. And I think one thing about the Rosen Hotel example to your point is it was they were able to do many of the nuanced solutions because all of his hotels were within a specific radius and the healthcare systems they leveraged were in that same radius. And those same strategies necessarily can't apply to a company that's nationally based.

That's right.

So let's talk about that leaks. I know you and I both have opinions on this. Practitioners, pontificators and practitioners. I think a lot of advisors in the industry today want to be talking about this stuff in your Words. Or. Or maybe your advice. How can an advisor take what they're pontificating so they're saying the right things, and apply them more to execution so they can become more practitioners?

So there was a saying we used to have back when I was. When I was a consultant in kind of the innovation practice at Gallagher, and that was.

If you want to be insanely successful as a consultant financially, you must do two things. One, you must talk about all the most innovative stuff you can find that is crucial. If you don't do that, you'll be seen as kind of stodgy and old and getting stale, and eventually you'll get replaced because there'll be a turnover with the person that you have a relationship with. If, you know, if the person came to your wedding, whatever, that person retires or switches jobs, the new person doesn't have that. And if you're just kind of stodgy and a little slow on your game, you're out. But the second thing that you must do is you must not implement any of those innovative things, because if you do, if you do, you have now embraced a certain level of unpredictability and risk. And there is a percentage of everything new that is, you know, that is slightly higher risk that will not go well. And, you know, and generally speaking, nobody has tolerance for that, and that will get you fired. So the joke is that, man, if we really wanted to be successful now, we did fine. I say that tongue in cheek. When I left Gallagher, the year I left Gallagher, my third year there.

I booked revenue, booked new, sold business of $2.2 million in a single year.

Year.

That wasn't my whole book. That was just what I sold that year. And that, back then, that was. That got me the ranking as number two globally for Gallagher.

So, you know, we did plenty. Well, nevertheless, you know, if we really wanted to make some crazy money, we'd stop doing all this innovative stuff and just talk about it and call it a day.

Well, I gotta. I'm laughing because I can. I remember you literally showing me one of your presentations.

And what you did such a good job of. And you might still do this today, I'm not sure, but when you would present an idea, I remember you walking. I forget what the. Which. Which prospect it was, but you literally showed me your presentation and you had, like, three different solutions. You were going to present them, but what you did such a good job with is you not only told them why it would work, you actually spent time showing them why it wouldn't work.

Yeah.

And why they.

Why not to buy this solution.

Why not? And I'll never forget, there was a slide said why not? Why you wouldn't hire me.

Yeah.

And your last bullet point was, oh, that hair, Lee.

Terrible. Yeah. It's apologies to all to have to be. Have it inflicted upon them.

But, but my point was you. You actually took the time to show them. Here's why it wouldn't work, though. You know, that, that subtle takeaway of maybe this isn't a fit, I think lent itself, I'm sure, to be advantageous for you, because when you have that takeaway, it almost. It starts. The prospect starts trying to convince you why they're a fit.

Right. And that's, that's my hope is that it would drive them there, but also at the same time, man, you don't want to have that client who doesn't ever want to do anything.

Yep.

I had one of my clients. It was a terrible, terrible matchup. They hired me because I broke their RFP and, and I was working with them, and they're a Fortune 100 and had over 200,000 members. They were everywhere. And I was their consultant, and I would bring them new ideas all the time, and they were totally unable to put them in. Like, it just wasn't going to happen. They hired me for one niche reason, and I was sort of doing that and doing well, and it was mildly, you know, innovative. Nevertheless, when I would bring them other new concepts, they're like, no. And finally they just said, you know what? You're. You can't bring us any more new ideas.

Just no mas. Uncle. Like, we don't want any more. If we want some, we'll ask you for them. And I'm like, okay, that's fair. Like, we'll just create a safe word and call it a day. And, and, and, and that, that worked all right. We were, we were, we were a very funny fit. But it was, you know, it wasn't a good fit. That was the problem. But you do want to attract people who are, who are there for it. Right. Who want to learn and grow and try new things. Now, not everybody's going to be there as a default, but, you know, as you, as you earn trust and introduce them to different concepts, you can hopefully find something innovative that everybody can do.

I tell you what, man. One takeaway from today's episode is I think we need to create a 10 Commandments of Benefit. Advising commandment. Commandment number one is you must talk about every strategy.

Never implement any of said strategies.

And those are the two commandments, that is, that is the law.

Ten, but we only need two.

That is the way in the law.

Let's wrap up here, dude, because I know you're busy.

Looking down from where you're at today with the Health Transformation alliance because you're working with some of the biggest companies in America. Right. And we've talked about what are they thinking, what are they looking at. If I'm an advisor listening, who is passionate, wants to try to become more of that practitioner. As you look ahead at 2023, we're doing this interview in early February. What are some of the things you guys might be looking up at? You know, looking at this year from the HTA perspective as big opportunity. If you're willing to share that, an advisor could say, yeah, that's a concept I could bring to my 200 life group.

Yeah. So a few items. We are around data. We're looking for fiduciary protection. We've got to be analyzing every claim every day, multiple times. And we're working to build a solution stack that we can layer up multiple vendors, get a direct feed that comes into them and that they're splicing and evaluating all those claims every day and that we're finding and eliminating waste. We haven't got that all built in place, but we, we've. Right now I have three employers who have every claim, every day evaluated twice by two different vendors that are not the carrier. Right. And the carrier doesn't love any of this, but it's, it's there. Second thing is flow. We need to get data being able to flow when and where it needs to go at the times it needs to. Third is financials. We need to be evaluating our financials, minding the shop, following all of our expenses, carefully tracking it appropriately, reconciling, performing the appropriate safeguards every year. This is outside of just fiduciary stuff. And we need to take every action that we might take and distill it into the financial impact. No more is it, oh, this is kind of a feel good thing. So I'm doing it. Or a walking challenge or a fancy new keto diet or whatever it might be. It's like, no, no, no, no. What is the financial impact? How is this helping my people if there is a clinical impact, that's not necessarily all clinical impacts come back to financials, so to say, oh, well, I'm just doing it for better outcomes. But I can't measure it in dollars. That's a cop out. Like you can measure it in dollars. You Just have to be creative about it. Now, it might be soft dollars, I admit that sometimes, but you shouldn't just give it up and say, I don't know, since I don't know how many heart attacks I might prevent. So I'm giving up on it completely.

Now.

Some of that does require large sample size, so I get that. I am, I do have the luxury of massive sample size. We've got millions of lives in the co op. So yeah, like, there's some things that we can do there, but you can work with vendors across their block of business to be able to get and validate across a larger sample even if you, your employer doesn't necessarily have it. So that's like data within clinical. Get your MSK in order, get your cardiometabolic disease in order to get your behavioral health in order. Those are like the big ones. I'm jumping into a bunch of other areas as well. Like within msk, there's, there's a lot of different solutions.

That, that can do a good job. I like the stuff that builds straight into the. My prior auth. I like to be able to have a little more command and control there within cardiometabolic. I'm freaking loving Walrus right now. It's a newer vendor that we've been piloting that just does heart attack and stroke survivors and then they can expand out from there to help with all other different types of conditions. But we sort of start there because it's one and a half percent of your people and you can get like $20,000 ROI. At least that's what's been published by a couple other, a couple other locations. $20,000 in savings per person. And then behavioral. You got to get that access and everything opened up. You can do that with aftermarket vendors and then finally within providers and sort of delivery. We're looking at advanced primary care. Getting it up. You've got to. If you don't have a primary care strategy, guess what? Every other hospital in town does. They will control the patient. If they control the patient, they control your wallet. If they control the patient and your wallet, they control the industry. So you are out of the game. If you don't have a primary care counter strike, you must find and lock down primary care access for your people. The music is starting to wind down. There's only so many chairs and the carriers are like laying across three of them like, like a lady with a large family and too many coats at the, you know, at the ballet recital. So you need to, you need to start Locking down access.

And then finally, centers of excellence. We're looking for centers of excellence that can give us good indexed access to major elective surgeries, et cetera, in a convenient way. I don't like airplanes in as many places we can get. And using that as a way to, to really start to control and narrow your network, but have it be invisible to your employees.

Dude, that was. This is why I wanted you on, man. You're, you're just full of quotes and, and no, the I, what I just took away was, number one, lean into financial over feel good. We need financial outcomes. And number two, I love the. If they control the patient, they control your wallet. That is every employer in America needs to hear that. Every broker who works with employers, you need to hear that. If you're letting the doctors control your impatient which is your employees, they're going to control your wallet and you're not going to be able to fix your health insurance costs. Last question and then I'll let you roll. Lee, tell us a little bit about broken health, broken benefits, your new podcast.

Hey, Broken Benefits. So my entire career came down to one giant break. I got a. I was a new consultant. I'd been trying for two and a half years to get a visit with the head of benefits at Comcast, Shawn Levitt. He was a legend in the industry. Comcast, it wasn't just a huge employer, but they were, they were an institution. Among the innovative employers, they were like one of the biggest, one of two or three of the biggest, also most innovative employers in the whole country. And so I finally got a visit with him and I went to him. I had no clients, I had no prospects. I had no, I had no references and I had no experience as a consultant. I knew a lot about health care working inside the tpa. And I talked to everybody and they're like, dude, he never hires consultants. He does. I mean, he hires him W2, but he doesn't hire consultants or brokers. Doesn't exist. He's got like 40x Mercer on staff. So, you know, glad you got a meeting with him. It'll be a good story and like, whatever. So I, I go to 30 Rock. I'm up above the studios at SNL. I get into his office, within a few seconds of sitting down, he goes, hey, you know, I took this meeting because I think you're interesting, but we don't hire consultants. I haven't for, you know, decades, but, you know, I'm always up for an interesting conversation. I said, absolutely. I said, listen, I've heard. You know, I've interacted with lots of people with whom you interact. I know you don't like consultants. Quite frankly, I don't either. I just became one. I realize that's hypocritical, but I want to do it different. I know that you've invented lots of great things in the industry. What could I. I said, I'd love your advice if I could reinvent and create a consulting practice that was, that would actually be useful to you. You don't have to hire me.

That's.

That ship is sailed. I get it. But if you. But a practice that would be useful to you, that you'd like to see exist, what would it be? Please help me. And to his credit, he's like, okay. He sat back in the chair and he just started talking and I wrote down everything he said. There were like five things. It's like, hey, you need to like swear a blood oath that you won't take any money from vendors. You need to, you know, be able to do disruptive things in the marketplace and not have it link back to me. I need a lot of anonymity and discretion. Like. And he went through a number of things, helped me to interact with other employers because we all get busy. There was this kind of stuff, I wrote it all down, I said, thank you very much. I went home, typed it up into an sow, sent it back to him. I said, hey, look, thank you so much. I am creating exactly the practice that you told me that you'd want. You don't have to hire me, but here's an sow if you want to, if you want to hire exactly what you want to build, and I'd love for you to be able to participate in that, make sure I do it right. And the guy, to all of our surprise, including his own, he hired me. So no rfp, no, no reference calls, no nothing. He just took a flyer on me. He should never have done it. That was a terrible decision. But I'm so glad he did. Completely changed my life. A few years later, I was near the very, very pinnacle of that entire industry segment. And then I got the life altering client of the HTA as their consultant across 50 employers. They kicked the tires on me for about nine months and then hired me.

And as a W2, wow, it's a phenomenal story, man. It's been fun to watch your, your ascendant, your ascendance into this industry because again, I remember meeting Lee Lewis here in Longmont, the, the sales director with Ameriben and now you're the Chief Strategy Officer of the hta. It's pretty impressive, man. I hope you're proud of yourself.

It's nice of you to say. I. I missed the whole punchline of that story. Shawn Levitt, after hiring me and making my entire career, right before COVID he dies tragically. He passed away.

And I went after that. As I'm working with all these benefits people, I'm like, oh, we need to find some words of wisdom from Sean. And I scoured the Interweb, and there's, like, no recordings of him anywhere because Comcast wouldn't let him record anything. And so because of that, there's nothing anywhere. I'm like, this is such a tragedy. I wish somebody had recorded, like, just an interview with the guy before we lost him so that we could have his wisdom and advice for future generations. And I was like, oh, I'm an idiot. You know what? Why don't I just do a podcast where I'll interview people who've made a massive impact on the industry just so we can get them on record sharing advice for the next generation. And so that's why I created Broken Benefits. I'm interviewing the absolute most impactful people who've been in the industry, have been in the benefits chair. And. And it's great. We've got the. It. Sean's number two at Comcast. We got the lady who ran Walmart for over a decade. We got the guy who changed the entire industry with the National Business Group on Health and ran Honeywell's benefits for a decade. It's awesome.

So that's cool. I know if you're an advisor listening in, you got to go check this out. One of the better podcasts, if not the best podcast I think we have in the industry, Lee, as far as, again, like you just said, people having a massive impact on the industry for not only this generation, but future generations. So from. From everybody else who listens to myself, dude, thank you for what you do for the benefits industry. I'm going to say it again. I remember when I met you at Amer, Ben, Here you are at such a pinnacle of what you do, dude. It's been fun to watch that ride. So everybody else listening in, I hope you took notes today. There's not a smarter man, Smarter man or woman in this industry than Lee Lewis. So, Lee, you just took 25 minutes to. To. To. To talk with us today, because this has been very, very special. Thank you, Andy.

You're the best. Anybody who's. Who's tuning in here is lucky to hear you and get your advice. I anyway appreciate you. Thanks for having me on the show. And if anybody wants me, just find me on LinkedIn and reach out. I'd love to help out.

Broken Benefits. Lee Lewis. Go get them. You won't be disappointed. Thanks, man.

Thanks, Dave.