How We Work
How We Work: Independent By Design
No commissions. No carrier incentives. No hidden revenue streams. Just transparent flat-fee fiduciary advisory.
Most healthcare advisors are paid by the very vendors they recommend.
We aren't.
High Stakes Healthcare is compensated through a transparent flat fee agreed upon in advance. We do not accept carrier commissions, PBM spreads, override bonuses, revenue sharing, or hidden incentives.
Our only objective is helping the Plan's fiduciary protect Plan assets — by overseeing vendors, evaluating reimbursement demands, and ensuring the Plan is governed with independent counsel.
Why Listen
Every Seat At The Table.
I've spent more than 30 years inside the healthcare system.
I've worked with hospitals, carriers, TPAs, brokers, PBMs, physicians, and employers. I've seen the inside of the chargemaster, billed claims, paid claims, negotiated for a PPO, negotiated for physicians, sold insurance, and negotiated stop-loss contracts. And since starting my TPA 22 years ago, I've seen how the system works from every angle.
Today, I work only for the Plan's fiduciary.
My loyalty is to the employer responsible for protecting the Plan — not to the vendors who profit from it.
The Engagement
Build. Hand Over. Walk Away.
Most consultants create dependency.
We create fiduciary capacity.
Our process is designed to leave your organization stronger than we found it. We evaluate reimbursement demands, oversee vendor performance, investigate claims, and train internal stakeholders to manage the Plan with independent judgment long after the engagement is complete.
At the end of the process, you own the governance framework, the data, the vendor relationships, and the fiduciary confidence to protect the Plan.
Scoping
Every Hand Is Different
No two Plans have the same challenges.
Group size, plan structure, vendor relationships, stop-loss arrangements, pharmacy spend, and claims history all influence the scope of fiduciary oversight required.
For that reason, every engagement begins with a strategy review before a final project fee is determined.
The Variables
What Determines Cost?
Plan Size
Number of covered employees and complexity of Plan administration.
Current Architecture
Existing vendors, contracts, carve-outs, and Plan design.
Fiduciary Exposure
Areas where the Plan may be overpaying or lacking independent oversight.
Advisory Scope
Level of support required to advise, document, and strengthen Plan governance.
The Standard
Our Promise
If we cannot identify fiduciary risks or opportunities that justify our involvement, we will tell you.
If we believe your current oversight structure is already sound, we will tell you.
If we do not believe we can strengthen Plan governance or protect Plan assets, we will decline the engagement.
We only work where we believe we can materially improve the Plan's position.
Our Philosophy
The Goal Is Not To Keep You.
The goal is to make you less dependent on people like us.
The healthcare industry profits from complexity.
We help Plan fiduciaries understand the obligations, control the data, and govern the Plan with confidence.
Who Is Protecting Your Plan?
Schedule a confidential strategy conversation and let's determine whether your Plan has the independent oversight it deserves.