Solutions & The Health Rosetta Model: Here's What Actually Works
There's a proven blueprint for high-performing employer health plans. Hundreds of companies are already using it. Here's what it looks like — and how you can start building toward it.
"The system was built around revenue — not your employees' wellbeing. Hospitals are paid per procedure. Carriers earn administrative fees on total claims. But once you understand the incentive structure, you can design around it."
Introducing the Health Rosetta Model
The Health Rosetta is a growing movement among forward-thinking employers, advisors, and healthcare providers who've decided the status quo isn't acceptable. It's not a product you buy — it's a blueprint of proven principles that, when applied together, consistently produce lower costs, better outcomes, and employees who actually trust their health benefits.
Hundreds of employers across the country — manufacturing companies, professional services firms, nonprofits, construction businesses — have adopted these principles and are seeing real, measurable results. This isn't experimental. It's a repeatable process.
Direct Primary Care
Accessible, unlimited primary care through a flat-fee physician relationship — keeping employees out of the ER and catching problems early.
Reference-Based Pricing
Paying a defined, fair amount for services — rather than whatever a hospital charges — creating real cost control on your biggest claims.
Transparent Pharmacy
Pharmacy benefit management with no hidden rebates — so you know exactly what drugs cost and why, and lower-cost generics are always prioritized.
Centers of Excellence
Routing employees to verified high-quality facilities for complex procedures — improving outcomes while dramatically reducing cost.
Fiduciary Advisors
Working with advisors who are legally and ethically obligated to act in your interest — not the carrier's — and who bring data, benchmarks, and alternatives.
Data Transparency
Owning and actively using your claims data to identify cost drivers, track plan performance, and make proactive decisions year-round.
Data Is Your Most Underused Asset
Imagine running your sales team with no CRM data — no conversion rates, no pipeline visibility, just a gut feeling. You'd never accept that. Yet that's exactly how most employers run their health benefits: paying hundreds of thousands of dollars with virtually no visibility into what's driving those costs.
Know which conditions and procedures are driving the most spend — before they become catastrophic claims.
Find out if employees are using high-cost providers when lower-cost, equally qualified options exist nearby.
See whether plan changes are actually making a measurable difference over time.
Identify care management gaps before they become expensive, avoidable complications.
Common Concerns — Answered Honestly
"Isn't self-funding too risky for a company our size?"
With stop-loss coverage, your maximum liability in any given year is capped. The risk is defined and manageable — often far less than the risk of absorbing 10%+ annual increases indefinitely. And level-funded plans are accessible for groups as small as 25–50 employees.
"Won't changing our plan disrupt our employees?"
Done right, the transition is seamless — and employees often end up with better access to care. Lower out-of-pocket costs and direct primary care access tend to be very well received. The disruption is usually smaller than employers fear.
"Our broker says we're already getting a good deal."
How would you know? If you don't have access to your own claims data, you can't verify that independently. A fiduciary advisor can give you a real second opinion — with benchmarks — at no cost to you.
Three Steps to Start Moving Toward a High-Performing Plan
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1
Ask your advisor a direct question "Are you a fiduciary — legally required to act in my best interest?" If the answer isn't a clear yes, or if they can't explain how they're compensated without referencing carrier commissions, that's important information.
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2
Benchmark your pharmacy costs Pharmacy is often the fastest-growing component of healthcare spend, and one of the most opaque. Ask for a transparent accounting of what your top 10 drugs cost — and what they could cost with a different PBM structure.
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3
Start the clock on next renewal — now The best time to evaluate your health plan strategy is not 60 days before renewal. It's today. Twelve months of lead time gives you leverage, options, and the ability to make deliberate changes. Don't wait until you're in panic mode.
Coming up next: The real cost of doing nothing — and what it looks like when a health plan is actually firing on all cylinders. Practical takeaways, the renewal trap, and your next step forward.
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