EP493: Revelations Mainstream CEOs Are Having About the Healthcare Market Right Now—Also, Some Advice, With John Quinn

Hello, all you great people trying to figure out how to do right by patients. Welcome to it. I was and am always extremely curious if any of what we talk about over here on Relentless Health Value has, in any way, percolated over to your average employer CEO—the ones who do not listen to this show, I mean.

For a full transcript of this episode, click here.

If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe.

This is what I try to figure out during my conversation upcoming here with John Quinn from Wellnecity® today, and I score some advice to boot for employers in the face of any of these revelations that they may have. That's what's gonna go down today, and this whole endeavor is a decent plan, if I do say so myself, because John Quinn chats up a lot of employer CEOs. He's certainly got a bit of a catbird seat there.

So, taking it from the top, I wanted to see how clued in these employer C-suites might be to a fundamental myth, which, if employer folks don't realize it is in fact a myth, it means that a whole lot of transformational power is going nowhere fast. And this myth is the mother of all myths: the "there is a market in healthcare" myth.

We've been on a tear about this for three episodes now, at least as it relates to hospitals and health systems. I'm gonna refer everybody to LinkedIn because Luke Trocchio put up a, I don't know what you call it, a reel, highlighting something that Shane Cerone said in episode 490.

And then I'm gonna tell you why whatever CEOs at self-insured employers are thinking here makes all the difference in the world. But what Shane said is this, "The myth is that we have a functioning marketplace, and we don't."

Shane continues, "What I mean by [there is no actual healthcare market], as somebody who's been a CEO of multiple hospitals and health systems, hospitals don't compete on price for patients. It … doesn't work that way. And so, we don't really have a normal market incentive to reduce cost or, in this case, the price of services in order to remain competitive."

Now look, and this isn't rocket science, but it needs to be said out loud. The reason there is no healthcare market largely is because self-insured employers have not insisted upon there being one.

Is that fair? I don't know. And whether or not it's fair is irrelevant to this point.

Self-insured employers pay for healthcare for, like, 160 million Americans. They are largely the demand curve. They are the demand side of any market that exists. Because you know something that doesn't our market make? You can't ask the supply side to create demand elasticity. You can't get a seller to get a buyer to buy or not buy at some price point. That would be like a comedy skit.

Except in this case, you know, patients die or go bankrupt because they can't afford care. So, it's not really all that funny. But if in this country we are depending on health system prices being constrained by a market, and then you don't have a buyer who doesn't buy when the price is higher than the buyer wants to pay or a buyer who doesn't buy unsafe stuff or low-quality goods or services, you're gonna get sky-high prices. Welcome to it right now.

Also, if there's no competition, again, no market. But competition a lot of times doesn't surface if there's no point in starting up a business because there's no demand for lower prices or higher-quality care. I mean, if no one cares if you have lower prices or higher quality, then how are you gonna attract patient volume or steal market share, right? Like, unless you're really good at marketing, I guess, or have accumulated market power.

I'll say this again. If our whole, the whole healthcare sector pricing structure is built on the myth that there is a market and then there's no market and employers aren't filling for whatever reason, the vital demand side role that they have to play for there to be a market, then, right … hello, 37% renewals like we see coming up in New Jersey. Listen to the show with Kevin Lyons (EP487, Part 1).

So, I say all this to say, do employer CEOs even know they have one job here? And I'm not talking about, again, whether or not this is fair, whether they're capable of pulling this off. I'm just distilling this whole thing down to this is the question that remains on the ground.

So anyway, this is first and foremost what I go after John Quinn from Wellnecity to figure out today: Where's your average CEO in this learning curve?

Now here's some demand curve optimism. The show from two weeks ago with Elizabeth Mitchell (EP491) from PBGH, the Purchaser Business Group on Health. In that show from a couple weeks ago, we talk about what PBGH members, who are very large employers, what they're up to. So, certainly go back and listen to that if you haven't.

Okay, so with that, here's my conversation with John Quinn from Wellnecity, as I have mentioned; and you'll get two things out of this conversation. Number one, a level set on what employers' leadership teams are figuring out and why they are figuring this out. (Renewal shocks and employees complaining about affordability much?)

But also how the mindset needs to shift in the C-suite for anything to really happen here. In other words, what's the assignment and what's some very top-line advice to get there? That's how I finish up the conversation with John Quinn today.

Do just wanna note that Wellnecity so kindly offered to pick up some of the tab to produce this Relentless Health Value show, which, as I keep saying is … yeah, it is expensive to keep this train on the track. People often forget it's not just what goes into the recording, the hosting, the producing, the editing of a podcast, but there also is a whole Web site and an API feed and headshots and graphics and transcriptions and a proofreader. It's a whole thing, guys, even if the host is a volunteer with a day job.

So, thanks much to Wellnecity for the contribution to the fund and for coming on the pod today.

John Quinn is CEO of Wellnecity. Wellnecity does health plan management for employers that self-fund their health plan. The key role Wellnecity plays is how do they help those employers better manage the spend category called health benefits.

This podcast, as I said, is partially sponsored by Wellnecity and also Aventria Health Group.

Also mentioned in this episode are Wellnecity; Luke Trocchio; Shane Cerone; Kevin Lyons; Elizabeth Mitchell; Purchaser Business Group on Health (PBGH); Paul Holmes; Peter Hayes; Healthcare Purchaser Alliance; Mark Cuban; Lauren Vela; Cora Opsahl; Andreas Mang; Jon Camire; Eric Bricker, MD; and Christine Hale, MD, MBA.

For a list of healthcare industry acronyms and terms that may be unfamiliar to you, click here.

You can learn more at Wellnecity and follow John on LinkedIn.

John Quinn is the founder and CEO of Wellnecity, a health tech innovator on a mission to measurably improve the quality and affordability of employer-sponsored health plans in the United States.

Under John's leadership, Wellnecity developed the groundbreaking Smart Hub platform, which integrates data from multiple vendors to simplify health plan management. Smart Hub enables organizations to measure ROI objectively, uncover savings, enhance member engagement, and reduce fiduciary risk. Building on this foundation, Wellnecity has launched its next-generation plan management platform, equipping HR leaders with real-time oversight, vendor accountability, and measurable ROI. The platform empowers leaders to act in the moment, redirecting spend, simplifying oversight, and delivering better healthcare for employees.

John is also the author of Benefits Revolution: The Next Generation of Employer-Sponsored Healthcare and is widely regarded as a thought leader in the healthcare space. He believes healthier businesses are built on smarter healthcare for employees, and that data is the key to driving this transformation.

Prior to founding Wellnecity, John spent 25 years at Andersen Consulting, Diamond Technology Partners, and McKinsey & Company. He advised Global 1000 companies and high-growth start-ups, helping them build new businesses, products, and channels. His expertise in digitized information and network effects has driven meaningful business model innovation.

John is a sought-after speaker on topics such as the benefits revolution, the power of data, fixing what's broken, and health tech leadership.

Helping organizations deliver innovation is his mission; fixing what's broken is his passion.

07:06 Why CEOs are looking more closely at healthcare spend.

08:06 EP397 with Paul Holmes.

08:21 How savings and health benefits are directly connected.

10:45 EP436 with Elizabeth Mitchell.

11:46 What missed earnings look like in relation to healthcare.

14:27 How costs have been shifting to employees for years, and why this doesn't work anymore.

17:36 EP475 with Peter Hayes.

18:23 What employers need to do instead of cost shift.

19:12 EP406 with Lauren Vela.

21:30 Why it's important to make health benefit changes at the speed of business, not at the speed of the benefits year.

26:17 Why is it important to put a finance function into your benefits?

27:10 EP488 with Mark Cuban and Cora Opsahl.

27:33 EP419 with Andreas Mang.

27:35 Why daily data matters.

31:10 EP487 (Part 1) with Kevin Lyons.

31:21 Why it's important to hold vendors accountable.

31:47 Why it's important to move on from vendors who can't hold up to your scrutiny and needs.

33:46 EP472 with Eric Bricker, MD.

34:46 EP471 with Christine Hale, MD, MBA.

Recent past interviews:

Click a guest's name for their latest RHV episode!

Dr Sam Flanders and Shane Cerone (EP492), Elizabeth Mitchell (EP491), Shane Cerone and Dr Sam Flanders (Part 1), Dan Greenleaf (Part 2), Dan Greenleaf (Part 1), Mark Cuban and Cora Opsahl, Kevin Lyons (Part 2), Kevin Lyons (Part 1), Dr Stan Schwartz (EP486), Dr Cristin Dickerson