S03E115 'Fixing Healthcare' to Reduce Waste & Improve Benefits with Donovan Pyle

Episode notes

Healthcare is swallowing budget and patience at the same time, and much of it is unnecessary. We sit down with Donovan Pyle, CEO of Health Compass Consulting and author of 'Fixing Healthcare', to expose where employer dollars leak out of the system and how to plug those holes without sacrificing benefits. Donovan has helped organizations with tens of thousands of employees save four figures per employee per year, and he explains why the fix starts with incentives, contracts, and visibility, not another network discount. We trace Donovan’s journey across carriers, brokerages, and consulting to show how misaligned incentives became the norm. You’ll hear how ACA medical loss ratio rules pushed insurers to vertically integrate with PBMs, why spread pricing inflates drug costs, and how cash prices can undercut “negotiated” rates. We break down the playbook employers can use now: request the 408(b)(2) broker compensation disclosure, move to a fiduciary advisory model, run a true PBM RFP with pass-through terms and audit rights, and carve out shoppable services with bundled prices at centers of excellence.