Caravus

A lot of employers are either already self-funded... or starting to ask themselves what making that shift would mean.

Over the next few weeks, we're going to break down the four core components that shape a self-insured health plan... what “best practice” actually looks like across each one of the following:

🔹 Stop loss — the risk protection layer
🔹 The administrator — claims, payments, and plan operations
🔹 The network — access to care (or reference-based models in some cases)
🔹 The pharmacy benefit manager (PBM) — where a lot of cost and complexity lives

Each of these plays a critical role in how a plan performs, how employees experience care, and how employers manage cost/risk.

More to come about each one individually in upcoming posts... covering what works, what doesn’t, and the impact this funding model has when done right.

Stay tuned! 📺

Today's smartphones 📱 have 40-50x more processing power than the first models. And yet, their price hasn't changed much.

So what happened... and what the heck does this have to do with healthcare? (We're getting there, we promise!)

To keep things brief... competition rewarded efficiency, and technological advances allowed them to deliver more with less, and utilization (and revenue) still rises. Win/win for company and consumer! 🏆

That's how most industries work.

Not the healthcare industry...

In healthcare, the system rewards:

🔹 New drugs
🔹 New procedures
🔹 New technology

But it does not reward:

🔹 Preventive care
🔹 Eliminating waste
🔹 Delivering the same outcome at a lower cost

Because when you reduce waste, you reduce utilization.

And when you reduce utilization… you reduce revenue. 📉

And in healthcare in the United States, revenue is still the name of the game.

So instead of becoming more efficient over time, the system keeps layering on:

🔹 More treatments
🔹 More complexity
🔹 More cost

All without removing expense at the same pace.

Now imagine a different reality where efficiency was rewarded the same way innovation is, delivering better outcomes at a lower cost actually won in the market, and 40–50x improvement in how we deliver care doesn’t feel so crazy when you’ve already seen it happen in your pocket.

Unfortunately, we’re just not there yet.