Cutting Costs, Not Care – A Smarter Health Plan for Employers
Healthcare is one of the largest—and most frustrating—line items in any company’s budget. Premiums rise year after year, often with little explanation, leaving business leaders and HR professionals stuck between two bad options: absorb the extra costs or pass them along to employees. But what if there was a way to deliver better healthcare for employees while dramatically lowering costs?
That’s exactly what Matt Ohrt, executive director of the Free Market Medical Association, shares in the latest episode of Take Charge with HELPcare.
Why Employers Are Overpaying
Ohrt explains that the real issue isn’t the cost of healthcare itself—it’s the layers of middlemen that drive up insurance premiums. “Healthcare is actually not expensive if you do it right,” he notes. “Health insurance is expensive because there are too many hands in the cookie jar.”
The result? Employers are paying $5,000 for an MRI that could cost $400, or $100,000 for a hip replacement that’s available for $20,000. Multiply those differences across an entire workforce, and the waste is staggering.
Direct Primary Care: The Cornerstone of Smarter Plans
According to Ohrt, the smartest employers are rethinking the foundation of their health benefits. At the heart of this approach is Direct Primary Care (DPC)—a model that restores the doctor-patient relationship.
Instead of rushed seven-minute visits, DPC physicians typically care for 500–800 patients and have time to provide preventive care, chronic disease management, and even direct text or phone access. That extra time means healthier employees, fewer referrals, and dramatically lower costs.
“Rushed care is not good care,” Ohrt says. “When doctors have time, they can actually address problems before they become expensive crises.”
Managing Big Costs with Smarter Strategies
Of course, primary care is just the start. Employers also need strategies to manage big-ticket items like surgeries, specialty drugs, and catastrophic claims. Ohrt outlines how self-funded plans with stop-loss protection give businesses more control while still guarding against financial risk.
For smaller employers, level-funded plans can provide predictable monthly costs while still offering transparency and opportunities to manage claims more effectively.
The key principle: this year’s claims become next year’s premiums. Employers who actively manage care costs aren’t just saving now—they’re preventing the double-digit premium hikes that frustrate HR teams year after year.
A Win-Win-Win for Employers, Employees, and Doctors
One of the most compelling aspects of this model is that everyone benefits—except the traditional insurance middlemen. Employers save money. Employees receive longer visits and higher-quality care. Doctors escape the “hamster wheel” of rushed, bureaucratic medicine and return to practicing the kind of care they were trained to provide.
As Ohrt puts it, “We need to move from a win-lose system, where insurers win and patients lose, to a win-win system that sustains over time.”
The Opportunity for Business Leaders
For HR professionals and business leaders, the message is clear: it’s time to treat your health plan like any other part of your business. Scrutinize costs. Demand value. Explore models like DPC and self-funding that give you control.
Cutting costs doesn’t have to mean cutting care. In fact, done right, it means better care at a fraction of the price. And for employers willing to rethink the status quo, that’s not just a health plan—it’s a competitive advantage.
Watch:
Be sure to subscribe on Spotify or Apple Podcasts, or watch the video edition by subscribing to the HELPcare YouTube channel.
If you know a family medicine practitioner — a physician, nurse practitioner or physician assistant — who would be a good fit for HELPcare Clinic, or a specialist interested in exploring direct specialty care, pass along this link to our HELPcare Careers page.
If you're an employer responsible for selecting and paying for employee health plans - check out how we've worked with like-minded partners to develop Health Insurance with HELPcare plans built on the foundation of HELPcare Clinic membership, such as the one Mower County has implemented.
And join us in September for special screenings in Austin and Rochester of this documentary co-produced by the FMMA and presented by our Minnesota chapter, that outlines the major problems in the U.S. health care and what we're doing to fix it.
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