Montana woman recognized among Fortune’s greatest world leaders | Don Brunell

Marilyn Bartlett ranked No. 16 for her effort to save her state employee health insurance plan.

Imagine sitting home and learning Fortune Magazine just listed you among the world’s greatest leaders? That’s exactly what happened to Marilyn Bartlett who led the effort to save Montana’s state employee health insurance plan from bankruptcy.

In April, Bartlett was ranked No. 16 on a list which featured global leaders including Bill and Melinda Gates, New Zealand Prime Minister Jacinda Ardern, Michael J. Fox and Apple’s Tim Cook.

“Our sixth annual leaders list is the home of the brave,” Fortune Magazine wrote. “These thinkers, speakers, and doers make bold choices and take big risks — and move others to do the same.”

When Bartlett took over the Montana’s employee health plan in 2014, the state spent $200 million a year to cover its 30,000 employees and their families. The plan’s losses were projected to top $50 million and state officials predicted it would go broke without radical changes. By the time she departed the plan was on solid footing and the state was saving millions without cutting benefits to employees or raising their rates.

Bartlett came with some unique qualifications. She had just spent 13 years on the insurance industry side, first as a controller for a Montana’s Blue Cross Blue Shield plan, then as the chief financial officer for a company that administered benefits.

Montana, like many large employers, self-funds its plan. That means it pays the bills and hires an insurance company or other firm to process the claims. More than half of American workers are covered by self-funded plans. Today, many employers are starting to follow Bartlett’s blueprint which starts with transparency.

As the boss in this arrangement, Bartlett assumed she would have access to detailed information about how much the plan, which was managed by Cigna, paid for procedures at each hospital. When Cigna told her the information was secret and not available, Bartlett’s demanded all of the information and began examining every detail of the contracts.

Her plan turned the payment system upside down. The state would set its own prices for the hospitals, insurers and drug companies based on rates set by Medicare as a reference point. Montana’s plan now pays hospitals a set percentage above the Medicare amount, a method known as “reference-based pricing,” making it impossible for the hospitals to arbitrarily raise their prices.

From the start, she knew she would have to tackle the staggering bills from the state’s hospitals, which made up the bulk of the plan’s expenses. It wouldn’t be popular because they also made up a significant chunk of hospitals’ profits, National Public Radio’s Marshall Allen reported last October.

Bartlett found a new pharmacy benefit manager that would not take any “spread” and would pass along all rebates in full. The immediate savings was $16 per prescription. “Spread” is the practice where a pharmacy benefit manager, for example, will tell an employer it cost $100 to fill a prescription that actually cost $60, allowing the pharmacy benefit manager to pocket the extra $40. The fine print in the contracts often allows it.

“Most importantly, Bartlett understood something the state officials didn’t: the side deals, kickbacks and lucrative clauses that industry players secretly build into medical costs. Everyone, she had observed, was profiting except the employers and workers paying the tab,” Allen reported.

In Bartlett’s view, employers should be pushing back against the industry and demanding that it justify its costs. They should ask for itemized bills to determine how prices are set. And they should read the fine print in their contracts to weed out secret deals that work against them.

That’s good advice for any purchaser whether it be government, business or non-profit.

Don C. Brunell is a business analyst, writer and columnist. He recently retired as president of the Association of Washington Business, the state’s oldest and largest business organization, and now lives in Vancouver. He can be contacted at theBrunells@msn.com.

More in Business

Hydrogen fuel cells gaining momentum | Don Brunell

But we’ve still got a long way to go before replacing fossil fuel-powered vehicles.

Business alliance serves women of African diaspora in South King County

Nourah Yonous launched the African Women Business Alliance in 2017 to find ways to lift women up.

Enumclaw Recyclers throws holiday recycling party

Enumclaw Recyclers is getting into the holiday spirit with its first-ever Not… Continue reading

Retail-tainment may save dying malls | Don Brunell

Brick-and-mortar shops are suffering; new interactive experiences could save them.

Enumclaw losing an (almost) necessity

After 25 years, Almost Necessities is closing shop.

The Greatest Generation is quickly slipping into history | Don Brunell

An estimated 389,000 of the 16 million Americans who served in World War II are alive.

A King County judge found the company misled customers into thinking it was a charity. Photo courtesy of the state Attorney General’s office
Judge rules Value Village deceived customers

The King County judge found the company misled customers into thinking it was a charity.

There’s more to be done than impeachment | Don Brunell

Congress can’t just focus on a single issue.

The power of reliable power | Don Brunell

We can’t take infrastructure for granted.

The wildfire season that wasn’t

Even though we had a break last summer, let’s take this opportunity to prepare for the next.

Customers Glow with drinks, food, entertainment

A relatively new martini lounge in Bonney Lake is now offering a live-entertainment series.

Caring for the dead, serving the living

Russ Weeks, funeral director at of Weeks Funeral Homes, speaks about his profession and how it’s changing with the times.