Recap: 2026 LoVasco Benefits Briefing

A Morning of Clarity, Context, and Constructive Strategy

LoVasco Consulting Group recently welcomed employer leaders from across the region to its 2026 Benefits Briefing in Detroit. What unfolded over the course of the morning was not a typical industry update filled with carrier renewals and compliance reminders. Instead, the event invited attendees to step back and examine a bigger question:

If healthcare doesn’t behave like a traditional market, how should employers respond?

The conversations that followed, covering hospital pricing, care navigation, pharmacy economics, and real-world employer decision-making, did not promise silver bullets. What they offered was something more valuable: perspective, context, and practical direction.

When Price Doesn’t Behave Like Price

The morning began with Shane Cerone of Kada Health, who framed the central tension in employer-sponsored healthcare. In most industries, prices are transparent, competition exerts downward pressure, and buyers can compare value before purchasing. Healthcare, however, operates under a different set of dynamics.

Hospital pricing, as we discussed, often lacks consistency or visibility. Employers may pay multiples of Medicare rates for identical services, yet those rates are negotiated in contracts few plan sponsors ever see in full. Cerone emphasized that the issue is not simply that healthcare is expensive. It is that the structural incentives embedded in the system do not reliably reward efficiency.

Quality, he noted, does not always correlate with higher price. Nor does greater market consolidation necessarily lead to lower costs. When provider systems grow through acquisition, pricing leverage often grows with them. The result is a marketplace where traditional supply-and-demand assumptions do not always apply—but can when employers start influencing price through their buying behavior.

For employers, the implication is not to disengage, but to become more intentional. Understanding how pricing is constructed—and how networks are negotiated—creates space for smarter purchasing decisions. Employers may not control the broader market, but they do influence how their own plans are designed and where their dollars flow.

The Human Side of Access and Navigation

If the first session focused on structure, the second turned toward experience.

Dr. Paul Thomas of Plum Health, along with Shannon Biergans of Advocate LLC and Dean Jargo of Fair Market Health, explored how employees actually encounter the healthcare system…and how those experiences drive cost.

A simple equation anchored the discussion: Cost equals price multiplied by utilization.

C = P x U

While pricing garners much attention, utilization patterns often begin with something more fundamental: access to primary care. Dr. Thomas described how smaller patient panels and longer appointment times—hallmarks of the direct primary care (DPC) model—allow physicians to address issues earlier and more comprehensively. When employees can access care quickly and build ongoing relationships with a primary physician, emergency room visits and unnecessary specialist referrals often decline.

The panel also clarified an important distinction between “navigation” and “advocacy.” Many navigation services are affiliated with insurers or providers. Advocacy, by contrast, is independent and focused solely on helping the patient understand options, costs, and trade-offs. When patients have the right information—and someone to help interpret it—they are less likely to consent to unnecessary procedures or overlook more appropriate alternatives.

Dean Jargo’s comments on transparent marketplaces reinforced this theme. For scheduled services in particular, price transparency can influence behavior, but only when paired with meaningful incentives and simplicity. If employees must navigate complexity alone, even the best-designed programs struggle to gain traction.

The thread connecting each perspective was clear: thoughtful benefit design begins at the “front door” of care. Strengthening primary care access, separating patient advocacy from financial incentives, and making transparent options easy to use can reshape downstream cost patterns.

Following the Money in Pharmacy

The third session shifted to what has become one of the most consequential drivers of employer healthcare spend: prescription drugs.

Trevor Daer of Granite Peak Analytics walked attendees through the evolution of pharmacy costs. Prescription drugs once represented a small fraction of total health plan spending; today, for many employers, pharmacy accounts for a quarter (or more) of overall expense.

The mechanics behind that growth are complex. Pharmacy Benefit Managers (PBMs) were originally established to adjudicate claims and negotiate pricing. Over time, however, vertical integration reshaped the landscape. Major insurers now own or are closely affiliated with PBMs and specialty pharmacies. While integration can theoretically create efficiencies, it can also concentrate negotiating power and obscure where profits are generated.

Daer described how rebate structures and formulary decisions create misaligned incentives. When revenue is tied to a percentage of drug cost or to retained rebate dollars, the motivation to reduce list prices weakens. High-profile medications such as GLP-1 therapies for diabetes and weight management, along with biologic drugs for autoimmune conditions, illustrate how clinically valuable treatments can also strain plan budgets.

Yet the tone of the discussion was not fatalistic. Employers, Daer emphasized, have more tools than they often realize. Federal reporting requirements now allow plan sponsors to request clearer visibility into pharmacy economics. Employers can evaluate whether their PBM contract aligns compensation with cost control…or whether alternative arrangements might better serve their goals.

The key is accountability. Employers routinely measure the performance of other vendors and internal teams. Applying the same scrutiny to pharmacy arrangements is both prudent and consistent with fiduciary responsibility.

Employers in the Arena

The morning concluded with an executive roundtable, featuring Rob Dancer of EDSI, Kevin Roach of MCHS Family of Services, and April Matalavy of First State Bank. Their conversation grounded the prior sessions in lived experience.

Each panelist spoke candidly about the balance between cost management and cultural responsibility. Healthcare strategy does not exist in a vacuum; it intersects with recruitment, retention, and organizational values. Moving toward self-funding, adjusting network strategies, or introducing new care models requires both financial analysis and employee communication.

One theme echoed repeatedly: even a strong plan can feel destabilizing if employees do not understand it. Transparency is not only about pricing data. It is also about clearly explaining why changes are being made and how they benefit both the organization and its people.

The panelists did not suggest that every employer must make the same choices. Risk tolerance, workforce demographics, and financial structure all matter. What they modeled, however, was a willingness to ask difficult questions and to move deliberately rather than reactively.

A Constructive Path Forward

By the close of the briefing, the conversation had come full circle. Healthcare may not function like a textbook market, but that does not mean employers are powerless participants. They remain significant purchasers, fiduciaries, and cultural leaders within their organizations.

Across sessions, several consistent principles emerged:

• Incentives shape outcomes.
• Strong primary care can prevent expensive downstream utilization.
• Transparency must be usable—not merely available.
• Pharmacy strategy deserves as much scrutiny as medical network design.
• Progress often comes incrementally, not all at once.

The 2026 LoVasco Benefits Briefing did not offer sweeping promises. Instead, it encouraged clarity: about how the system works, where misalignment occurs, and where employers can begin to exert influence.

For organizations willing to examine assumptions, hold partners accountable, and approach benefit design strategically, the path forward may not be simple. But it is navigable.

Interested in joining the wait list for our next Benefits Briefing? Drop us a line to request access so you don’t miss out when we announce the details of our next event and open registration!