Cutting the Gordian Knot: Finding True Balance in Self-Funding

July 30th, 2019

Presented by Dr. Andrew Murray, chief medical officer for EBMS, at the 2019 EBMS Health & Business Symposium

In this inspiring presentation, Dr. Murray described how our traditional healthcare system is failing its stakeholders, and how self-funded plans can overcome those failures through a “True Balance” approach.

Dr. Murray first explored the factors driving up medical costs, then examined each one with an eye toward pulling out a “takeaway” point that self-funded systems can use to their advantage.

True Balance involves finding innovative ways to juggle competing interests in healthcare. The three things every plan strives to balance are:

  • Ways to improve care
  • Ways to simplify the process
  • Ways to reduce costs

Pursuing any one of things too aggressively means losing sight of True Balance. For example, when we focus only on reducing cost – through strategies like eliminating services or restricting formularies – quality of care can decline, along with patient outcomes and member satisfaction.

The True Balance approach applies a variety of strategies that lead to appropriate care, which drives better outcomes for members at a lower cost to employers.

Dr. Murray explained his vision for achieving True Balance in any plan, by making plan decisions proactively and employing innovative models of care delivery. This requires a new way of thinking and a new set of tools. Above all else, it requires rethinking the old reliance on traditional PPOs. Instead, Dr. Murray described how plans can curate a hyper-local care network composed of the best access points within a community.

At the end of his presentation, Dr. Murray walked us through the journey of a fictitious patient named Sally, showing how a balanced care delivery system can improve her experience and bring about cost savings and healthy outcomes. This allowed the audience to better understand the value of the True Balance approach.

See Dr. Murray’s full PowerPoint presentation >>