Dr. Eric Bricker, MD is a physician, a co-founder of Compass Professional Health Services, now part of Alight, and the founder of both AHealthcareZ and Texas Family Insurance. His content is rich and deep and he’s a must-follow for those in healthcare.

Q: Tell me about AHealthcareZ and what you’re working on this month. 

AHealthcareZ posts 3-5 educational videos per week on healthcare finance. I have several thousands of email subscribers and close to 100,000 viewers on Linkedin. It’s a fantastic cross-section of healthcare. We have major hospital system CFOs, the Chief Medical Officer of a major health plan, executives across the industries, HR, finance, physicians, nurses, and more. I focus on where money influences the care of the sick. This summer I’ve spent time on prescription costs–a major trend is the consolidation between healthcare insurance companies and Pharmacy Benefit Managers, CVS Caremark-Aetna and Cigna-Express Scripts are two examples.

Q: How do you think healthcare in the US will look in 10 years?

It’s hard to know. It’s helpful to look back. What did healthcare look like 10 years ago? The Affordable Care Act (ACA) had just been passed and one of the biggest things since then is 10-12 million have gained healthcare insurance coverage. The disruption from COVID, the job losses and economic impact, and how coverage is achieved, are likely to shape policy for those under 65. Will subsidies be extended? Will there be a public option? For those with Medicare, Medicare Advantage (private plans which currently cover one-third of retirees) are popular and will likely take market share from traditional Medicare. The common theme is likely the federal government funding healthcare through private insurers.

Q: What are some lessons you learned from your time as co-founder and Chief Medical Officer of Compass Professional Health Services?

I learned how to sell and how not to sell. I learned a lot about teamwork and leadership. The C-suite, in most cases, has not made their health plan a priority. There are exceptions, particularly with older populations or firms with a competitive labor force but some firms are cost-shifting or not providing extra subsidies for family coverage. It’s a question of prioritization. The strong economy concealed some of this and they have a lot to balance as leaders. There are some notable exceptions. John Torinus of Serigraph and author of the book The Company That Solved Health Care begins his speeches by apologizing on behalf of all the CEOs in America for having not prioritized healthcare. If we don’t change, things will remain the same: high costs and medical inflation of 2-3x general inflation.

Q: What advice do you give friends and family about health care, purchasing decisions, whether it be coverage itself or at the point-of-care?

I mostly talk about point-of-care decisions, decisions that involve pulling out your insurance card and/or swiping your Visa card. Caveat emptor. Buyer beware. Question things. If a service is denied by insurance, question it. If you get an out-of-network bill for an ER physician, question it–you can push back. Just because they say it’s X doesn’t mean it has to be that way. You can’t be too much of a rule follower; many of the rules are meant to be broken. 

Q: What kind of health care coverage do you have for your family? My family is on a sharing ministry plan (a non-ACA plan with much lower premiums and but higher cost-sharing at point-of-care than marketplace plans).

Q: What are the biggest fads in healthcare? What are the least appreciated innovations? 

The technology stuff, big data, machine learning, AI. Healthcare care is a services business, driven by human interactions. It’s analog. Many of those interactions are irrational. That makes it hard for big data to impact it in a meaningful way. On innovation, simple things like washing your hands, clean drinking water, sanitation, air conditioning can’t be understated. Imagine being sick in the summer in a hospital in the South without AC? These aren’t big money-making markets. A responsive government is also pivotal. An area of healthcare not likely to be solved with health intervention is the obesity epidemic in America, one of the greatest health threats that this country faces.

Q: What can healthcare learn from other domains?

Humility. As a physician I tend to be stubborn and arrogant, which is detrimental. If CEOs, brokers, consultants, nurses, doctors can learn more humility, that would go a long way to alleviate suffering. Things are changing. The increase of women in the profession is a demographic saving grace. They’re a growing force of empathy and humility. 

Q: How should health care purchasing success be measured? Claims reduction, Net Promoter Score (NPS)?

It has to be less expensive. There’s so much waste and the savings can be put back to better use: savings to shareholders, money back to the employees or taxpayers, money to help send employees’ kids to college. We are making choices individually that result in waste. To redirect that to more productive uses is huge.

Disclosures: my personal healthcare coverage is a $5,000 deductible cost-sharing plan (non-ACA compliant). Healthcare investments: long CI, HQY; TDOC (short via long puts). I have a Lively HSA and also have an affiliate agreement with them. I also consult for Paytient.co. I worked at Compass Professional Health Services from 2015-2017.

Photo by Marcelo Leal on Unsplash