1. Healthcare isn’t just a design problem — it’s a behavior problem

Most companies assume the solution to rising healthcare costs is better plan design. But Matt argues that the plans themselves are often already good — the real issue is how employees use them.

Employees are expected to behave rationally inside an extremely complicated system. But the reality is that most people don’t fully understand their benefits, and they only think about them when they urgently need care.

That leads to expensive decisions — like going to the ER for primary care or choosing a $3,000 MRI when a $450 option exists nearby.

“Every plan has an Achilles heel: it requires employees to act rationally 100% of the time.”

The takeaway: HR leaders should focus less on redesigning plans every year and more on influencing employee behavior inside the plans they already have.

2. COVID quietly blew up the benefits ecosystem

One of the most surprising insights from the conversation: the average employer health plan used to have about five benefits. Today, many have 35–40.

During COVID, companies rushed to add new tools to solve urgent problems — telemedicine, mental health platforms, disease management programs, cost containment vendors, and more.

The result? A fragmented ecosystem where employees are expected to navigate dozens of apps, websites, and phone numbers.

“Employees forget everything from open enrollment about 45 minutes after they leave.”

Instead of improving outcomes, this explosion of point solutions often increased costs because employees don’t know which tools to use — so they default to the most expensive care options.

3. The most powerful moment in healthcare decisions happens outside the doctor’s office

One of the most interesting shifts Matt has seen: healthcare decisions aren’t happening in clinical settings anymore.

Many employees today don’t even have a primary care physician. Instead, they’re making healthcare decisions in everyday life — at the grocery store, in the car, or at soccer practice.

That means a $60,000 medical decision might happen in a parking lot with zero guidance.

“If you can be with someone at the moment of decision, 94% of the time they’ll take your advice.”

When employees are given clear guidance in that moment — like directing them to a lower-cost provider — they overwhelmingly choose the smarter option.

The key isn’t just education. It’s timing.

And that insight leads to better decisions across the company.

4. Incentives work far better than punishment

Many companies try to control healthcare costs by adding financial penalties — higher deductibles, bigger ER copays, stricter plan rules.

The problem? Employees often don’t understand the penalties until months later when the bill arrives.

Matt argues the opposite approach works much better: reward the right behavior.

“You can financially disincentivize people. But if you financially incentivize the right actions, behavior changes fast.”

He shared one example where a company offered a $99 gift card for preventative colonoscopies. Demand surged so quickly that local clinics asked them to slow down referrals.

Why it worked:

Employees had a clear action to take
The reward was immediate
The process was easy

Small incentives can drive massive savings by catching problems early.

5. HR doesn’t need to solve everything at once

Healthcare costs feel overwhelming for HR leaders because they’re often asked to fix the entire system.

But Matt recommends starting much smaller.

Pick one expensive behavior — like excessive ER usage — and build a simple communication campaign around it.

Send a weekly message explaining the alternative option and why it matters.

Track the results.

“Don’t try to eat the whole elephant. Solve one problem and show the results.”

Once HR can demonstrate real savings from one targeted change, it becomes much easier to get executive support for bigger initiatives.

6. There are no silver bullets — but there are sequences of solutions

Healthcare has a long history of chasing the next big fix: new plan designs, transparency tools, new vendors, new regulations.

Matt’s perspective is more practical.

“There are no silver bullets. But you can fire a series of silver bullets in sequence.”

Real improvement comes from combining several things together:

Clear communication
Simple navigation
Behavior incentives
Better timing of guidance

When those elements work together, companies can actually bend the healthcare cost curve — while improving the employee experience at the same time.

And that’s a much more achievable goal than trying to overhaul the entire system overnight.

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