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The Health Guardianship Podcast is an ongoing dialogue with healthcare professionals, policy experts, and innovators who are unraveling the complexities of the US healthcare system in order to create new solutions to guard health. Join the conversation and become part of the health guardianship movement!
Mike Morris
Josh Taylor: [00:00:00] We are very excited by the opportunity to talk to Mike Morris, CEO of a steel manufacturing company here in the United States and Mike's journey really to help solve some of the healthcare trends that were inside of his company and really talk about what it's been like to work with health guardianship and bringing health guardianship into his team.
Josh Taylor: So Mike, if you could start us off by talking about your journey when it comes to. Um, dealing with your benefits, cost trend and what led you to selecting the team with Bowtie Medical?
Mike Morris: Yeah. So really the story for me starts in 2009 when I had the opportunity to really take over as a CEO of another company.
Mike Morris: Um, And I really started to look and anytime I take a opportunity on, I start [00:01:00] looking at the big buckets of cost and where the opportunities are to make my company more profitable, make it a better place for my employees. And I really started to look at a trend that was starting to be a huge burden on the company.
Mike Morris: Again, healthcare is a, is a very honorable thing that companies want to provide the best healthcare possible to their employees. It's a great benefit. And we want to maintain, at least in my career, very high quality healthcare. But we need to figure out ways Of attacking it on the cost side. So, you know, what's always stuck with me, uh, in anything is how do you get the highest quality at the best price?
Mike Morris: And that transcends whether it's healthcare, whether it's commodities that you're buying, whether it's raw materials, whatever that is, how can you buy the best of quality at the best price? So we, we worked in that company to try and figure out ways to, [00:02:00] I'll say, disrupt the way healthcare, we were paying for healthcare.
Mike Morris: And, um, you know, we made some progress. And then I rolled into a position where I didn't have P& L responsibility for a few years after that. And then I joined this organization in 2015. And I really just picked up with my team here where I left off there. Trying to figure out disruptive manners in which a company could combat these very high healthcare costs.
Mike Morris: Again, we want provide high, uh, high quality health care, but we were looking for, how do we reduce our overall costs? Because this, uh, healthcare costs is a major component of our, of my company's bottom line. So for a period of nine years, we, we worked pretty much weekly on how and what can we do to affect this overall spend and still provide good, uh, benefits to our employees.[00:03:00]
Mike Morris: So. In about 2000 and, uh, let me see, 17, uh, we broke ways with, uh, one of our major, um, healthcare, uh, third party administrators. So we're self insured. So all the bills we pay, we don't, even when we had a major TPA out there representing us, uh, one of the big names, um, it was almost insulting to me how they went about it and how the brokers interacted with us.
Mike Morris: And it almost to me seemed like a backdoor deal all the time. So there are people in the back room discussing how they're going to figure out how we pay for healthcare. And I, and I just didn't like that. It felt I had no control over my, my company's healthcare. So then we partnered up with a company that's based here in Northeast Ohio as our brokers, and they have done a nice job in at least putting in front of us.
Mike Morris: Change opportunities. So, at that point, we decided that we were [00:04:00] going to engage in a reference based pricing system. And, all the particulars in that sounded very good, and again, I pride myself and my staff for being pretty intelligent people and understanding what we were getting into, uh, and it worked pretty well for about the first year.
Mike Morris: Um, and then major medical providers kind of got wise to what that third party was going uh, administer. I shouldn't say that that reference based pricing was starting to show and they didn't like it. So then they were asking us when we had a scheduled procedure for an employee and I've been to one.
Mike Morris: It's quite emotional to me. Um, we had a gentleman here that, um, had been diagnosed with cancer. Uh, so it was prostate cancer and they, uh, A major health care provider said they would not even see him unless we provided 50 percent of the estimated cost of his care up front. Uh, so we battled [00:05:00] back and forth on that.
Mike Morris: Meanwhile, we have an individual that has been diagnosed and is very sick. Uh, and in those instances, Sometimes hours matter, right? When you're dealing with something that severe. And at that point, I just really said, um, the cost of healthcare has to, I have to put the interest of my employees before this, so.
Mike Morris: At that moment, I can remember as clear as day. I decided this, this isn't the way we cannot, um, negotiate on the back end and then medical providers get wise that, and then hold us hostage on the front end for payments, this, that the other before they'll see an employee. Um, so we went back to our broker and said, look, we need to find something that's different, new.
Mike Morris: Uh, and that's where the engagement. that bow tie represented. And again, I remember that lunch very, very distinctly. Um, and we had a very good exchange. And when I [00:06:00] walked away from that, uh, with the doctor and his team, I said, this is, this is what we need to do. So when you look at our overall healthcare, uh, we have a very, very rich healthcare plan.
Mike Morris: Our employees pay hardly any deductibles and hardly any premiums. And we want to continue to offer that because as everybody knows, uh, the employment landscape is very challenging these days. So if you can offer something that gives you just a bit of an edge over the, uh, company down the road, and you can, first of all, hire and retain good employees, we want that edge.
Mike Morris: So we have always been about providing good wages and good benefits[a].
Josh Taylor: your story about reference based pricing is actually something that many employers share that the hope of saving through a reference based pricing structure doesn't actually lead to that over the long term because [00:07:00] it's creating more headaches really for everyone in the health plan, you had mentioned when we were chatting earlier, uh, Firouz that when you had your first meeting with Mike, You could tell that there was a kindred spirit or a like mindedness around benefits.
Josh Taylor: Could you share, Firouz, what Mike said to you?
FD: my experience before meeting Mike was, most CEOs, they were very superficially involved with healthcare. They really didn't have, uh, uh, You know, grasp of what is it that is driving their cost. When we went to that lunch meeting that I remember, uh, very distinctly as well, as soon as we did the introduction and so forth, I asked, uh, you know, so why are we here?
FD: And Mike said, right, looked into my eyes and he said, I'll tell you why I'm here. I am sick and tired of healthcare fleecing my company, my employees, and my country. I said, wow. And that was the point of the connection. I said. This man understands and is looking for answers, uh, for the question that has basically deep insight, uh, [00:11:00] insight.
FD: So that was the first connection, and therefore I went deep and said, These are from my studies and research and the book written. These are the causes. This is why you're absolutely correct. That the healthcare or what we call the sick care is fleecing your, and there's no end to it unless you decide to change.
FD: And Mike and his leadership team were ready to change. They had come to the table to look for a alternative, innovative concept to change the course.
Josh Taylor: Can you talk about the process as a leadership team to communicate with the company some of the changes that you were making?
Mike Morris: Yeah. So, you know, we [00:12:00] are part of the United Steelworkers local here at our plant at our both of our plants, matter of fact.
Mike Morris: And so, um, the process of change is a very slow wheel to turn. Um, we have worked very hard in the first years. Um, so 2015 16 I worked very hard to build relationships with leadership in both plants, uh, for the, for the United Steelworkers.
Mike Morris: Now we had a bit of a black eye because when we moved from the traditional, um, you know, third party administrator, the big box stores, as I call them, of healthcare providing, uh, to the reference base, we did have some chaos there and that, that, that wasn't easy then to say, okay, we got it wrong. And now we're going to do something else.
Mike Morris: And that takes a bit of education because again, steel companies generally are [00:14:00] lethargic and they, they don't change very thoroughly. Very quickly. So we work very hard with people and communicating that change is inevitable and we involve our union leadership in the decisions we make up front so we don't just spring stuff on them.
Mike Morris: Um, so. You know, there's lots of different ways to do this. There's the health savings account way where you put money in employees pocket, you let them make their decisions. But again, most companies that I've found, uh, at least that I've worked for, they have a very high match. So it's actually free dollars and they still don't make great choices with their healthcare.
Mike Morris: And then they have physicians that they've had for years that they trust. And the one thing that the, that, uh, the doctor really, um, probably impressed upon me more than anything. And I really hadn't thought about it until we had the conversation is how they keep you in the system and how they are designed to keep generating money.
Mike Morris: By [00:15:00] keeping you in the system So with the guardianship and with Bowtie, we have now set a path.
Mike Morris: And again, is it, is it where we want to be? No, because we never accept where we are. It's always about how do we get better tomorrow, but now at least we have a fighting chance. So [00:16:00] the Bowtie group came in, they set up a clinic here on site. Um, and we've got a gateway now for people to come to the clinic on site here and their first touch is with a bowtie representative but until we really partnered with the guardian and bow tie, um, we had a lot of lip service.
Mike Morris: and not so much action. And I also said to the doctor in that lunch, you know, if I'm going to put my faith in you, I don't want to not see you for four, four, four years. And he has been true to his word. He is very upfront, very, very visible with us in, in how we go through this. And he's an extremely busy man.
Mike Morris: I know he is. But, uh, this is kind of something that's near and dear to his heart, and it's a, and it, [00:18:00] to me, it's a, uh, testimony to his credit, his character, and, uh, what he's trying to do.
Josh Taylor: One of the things that's interesting about the way that you started with health Guardianship is you've essentially created kind of a, a, a test environment where you have a control.
Josh Taylor: There was one section of the company that did not have health guardianship to begin with. And another that did have health guardianship. Can you talk about some of the reasoning for setting it up that way? And what you've been able to see inside of the data between those two?
Mike Morris: Yeah, so we have two, two sites.
Mike Morris: Uh, one of the larger sites is where, uh, my, my office resides. And so, The bulk of the health care expense comes out of this larger site. So we wanted to, again, as we adopted this and kind of polished the edges, if you will, the core was right. There's no doubt about the philosophy and the core and how we were going to approach this.
Mike Morris: All the components were right. But with anything, you have some polishing to do and And how does things kind of really when [00:19:00] the rubber hits the road, how does that work? So over a period, we kind of worked all that out and then we said, okay, it's a point now to roll that out to our other plant, which is really a 10 percent of the employment base of the operations here in the U S.
I have learned more [00:22:00] from him. Uh, Mike and how to make decisions and kind of out the changes than anybody else. Again, I made the comment that I heard from him and he said three years is a short term for a change. So that tells me that insight this man has about how to bring up an effective chair, a change.
FD: So the first year, uh, with that concept, we went and, as you said, we, Rolled out the guardianship to uh, uh, kind of actually smaller portion of the, of the employees. And then after reviewing the results and the, and and so forth, now we are ready to roll it out to the other side and expand the scope. I'm[b] very interested in looking, in hearing Mike's point of view in terms of, uh, with his vision and with his leadership, what are [00:24:00] the next levels of, uh, Kind of the targets that he would like to to capture and conquer.
Mike Morris: Yeah. So, you know, as any, uh, business leader, you, you have to go inside the numbers.
Mike Morris: So I'll just talk in general terms about numbers. So, you know, we, we have a benchmark that we look at for like sized companies that offer benefits on the same par as do we. And we started that benchmarking process in 2015. When we were a part again of a third party administrator was one of the very large third party administrators in the country.
Mike Morris: Um, and that was the benchmark. So when we did go to the, um, reference based pricing, we did, we did see a separation from what We'll call the index to what we were doing and, uh, but it was very difficult. It was a fight every day to, uh, negotiate these on the back end. As I mentioned earlier, [00:25:00] we had a, uh, one situation that got very, very intense with an employee that had been diagnosed with a very serious cancer.
Mike Morris: Um, and we saw the, the, the door starting to close with how we were. Uh, trying to approach thing with things with that reference based pricing. So, uh, at that time we had saw about a 12 percent separation from the index. So we were doing about 12 percent better than the index. Um, but there were challenges there that weren't fundamentally right.
Mike Morris: And just as being honorable people, we said this, this can't be the way that we conduct business. So through the period of time for which that we, uh, partnered with Bowtie and the Guardian ship, uh, we're now state looking at the index and we're about 20 percent below that index. And that's real dollars.
Mike Morris: That's not phony money. That's real dollars. And what I tell the employees is this, You know, it goes back to [00:26:00] really what I said earlier. We want to provide good health care. So high quality, but lower costs. And at the end of the day, we have a profit sharing program. That money that you are saving by being good stewards of how you spend our health care dollars will go back in your pocket.
Mike Morris: So who would rather you give it to? Uh, the medical systems who continue to expand and offer all kinds of things. Uh, do you really need valet parking when you go to the hospital? Perhaps. I don't know. I would rather our employees put that money back in their pocket to provide, uh, a summer vacation for their family or to provide, uh, a little extra For the holidays or to be able to, you know, swing, maybe, uh, a child going to college.
Mike Morris: That's what I'm all about is I want to give our employees those benefits coming back to them because we are attacking how we spend our health care dollars[00:27:00]
FD: for the record. This is the first time I'm hearing the separation from the index, which is, uh, Uh, as music to my ears that gotta keep you honest,
Mike Morris: Doctor,
FD: we can't. But because, uh, frankly, we have internally, uh, we have as I don't know if you've seen the numbers again, despite the fact that we only had one year and during this one year, we have not implemented some of the tools that would allow us to, uh, deliver more saving.
FD: And those are it. Cash upfront payment. Those are impacting some of the pharmaceutical spendings, but nevertheless, we have as a part of our services, uh, we keep an eye on the basically where the holes in the system are, where the areas of the waste are, and in Mike's company, one [00:28:00] of the areas are the pharmacy, which we are tackling it the second year.
FD: But nevertheless, there's no With those limitations the first year, we have an internal control actually. The internal control numbers, uh, shows that basically people who use the, uh, Bowtie Health Guardianship versus people who didn't use those, you know, union workers and so forth, The delta on the cost, uh, between these two groups is about 33 percent during the first year alone.
I think we have on both sides, we have early indications that we both have made the right choice. On his side. Uh, to, uh, allow us this honor of serving his company on our side partnering with really the visionary group that not only has allowed us to deliver our services, but is engaged and committed to allow us to continue to carry the path of, uh, change.
FD: As he mentioned, go to the second site, you know, probably tackle the issue of the pharmacy and the rest of it. [00:30:00]
Mike Morris: Yeah, absolutely.
Josh Taylor: You've just finished the first year of health guardianship entering into year two.
Josh Taylor: Um, what is different in your mind about the type of data, the performance of the plan so far heading into year two in your mind?
Mike Morris: So, you know, every touch point that our employees have had with. Uh, the guardianship on bowtie, uh, is positive. Okay. Now, does that mean that every employee gets exactly what they think they should get? No, let's face it. The reality isn't what I can give you. For instance, I was yesterday out, uh, in the operations and I talked to her, um, union president and I asked him about, you know, how are you getting any feedback from the guardianship and you know, the, the onsite here.
Mike Morris: And he said 99 percent is all positive. You have the one person that again, doesn't matter what you do, they're just not going to be happy. But you know, to me, uh, I'm always the 80, 20 rule, right? If 80 percent of the time things go well. Life, life's pretty good, right? I mean, you just, so I'm very pleased, but what, what I know is this, and this is what I talked with my staff on every other Friday when we, when we meet on healthcare is [00:32:00] it's educational on the front end, because no matter how much we blitz this thing from a communication, people still don't get it.
And even within my own family, because again, [00:33:00] people are so accustomed. It's ingrained that culture. Well, my doctor said to do this. And my doctor said, and that's fine. Bow tie doesn't challenge the doctor. They challenge maybe where they're being sent for the, what they do challenge where they're being sent for the, for the, uh, uh, for the care.
Mike Morris: And that's all we're asking is just, let's have options so that. If a knee replacement is, uh, your doctor says you need to go to X and it's 120, 000, you can go to Y. Same, same or better quality for 70, 000. That's real dollars. And that's what we're trying to attack.
Josh Taylor: are there some simple steps that [00:34:00] you could encourage other CEOs to take when it comes to these healthcare trends?
Mike Morris: Well, I think right now health care controls, uh, the U S and health care cannot continue the way it's going. So my, my, uh, cry or call to action from other CEOs, whether their company has 300 employees or 30, 000 or 300, 000, if we don't start to combat this as, uh, What I call the people that pay the bills in this country.
Mike Morris: Um, we're, we're, we're in serious trouble. Um, there are so many pressures on the revenue dollar that comes into these manufacturing facilities, whether it's healthcare, whether it's taxes, whether it's regulation, uh, whether it's, uh, competition from, uh, you know, um, overseas manufacturers. And it's just one other nail in the coffin of us manufacturing.
Mike Morris: And, uh, I just [00:35:00] beg everybody, uh, engage with Guardian, engage with Bowtie, let's create a coalition, uh, that we can really perhaps go to our nation's capital, uh, enforce and start to get people that are the lawmakers in this country. And I'm not about regulation. I'm about free markets and capitalism, but free market capitalism has to be controlled a bit.
Mike Morris: And I just think we need to, we really need to change the way we do health care in this country. And that's not a government run health care. Uh, again, capitalism wins the day every day, but, uh, right now with nonprofits and how they, um, are controlling how medicine is administered. It's a real scary proposition for us now and we'll only get worse in some, unless something changes.
Josh Taylor: Well, you had said something earlier when you were talking about one of your broker partners that you [00:36:00] started working with, that they gave you, uh, the ability to understand your change opportunities. That you were essentially empowered with the ability to make choices, better choices as a company. And that's essentially what you have done for your employees by bringing in health guardianship.
Josh Taylor: It's really about establishing and, or restoring choice for them and their families. That they have the ability to have options on the table from a quality metric and a price metric. So that they're saving themselves money, but even beyond the cost to your point, it's about the quality. Sometimes some of these interventions are being pressured on your employees and they think, well, I guess I have to do this and yet they're going through a invasive procedure that maybe they didn't have to go through.
Josh Taylor: Maybe there was an alternative that could have saved them the pain and the rehabilitation. And so you yourself are giving your employees that change opportunity.
as Mike said, There's a very tight pressure on every dollar revenue that comes to his company and other companies. He runs a three shift, uh, manufacturing. And so every person missing work, uh, for that shift has a chain effect, uh, to the rest of them, work behind and so forth.
FD: So, uh, again, we haven't started, uh, really doing this, but we will do this as a part of our reporting that we would, uh, provide to. Uh, to employers and to our [00:38:00] clients is really that hidden cost of loss of productivity, especially in a very, uh, productive, intense manufacturing like the one Mike has. And I'll give you one example, and I'll ask Mike to make a comment before we close, is We realized there was a employee who basically faints, has fainted a couple of times. One time we basically helped him there with our on site guardian. The other time they had to call an ER ambulance and so forth, which you know how much that cost on itself. So he gets up early, comes in, has no breakfast. He basically had to faint from the low [00:39:00] sugar. Uh, so what we said in the, the our on site clinics right in front of the company, I instructed our guardian to start putting protein bars and energy bars and basically walk around and offer them for free.
FD: Uh, because a dollar, Uh, a worth of the energy bar is much less expensive than a, uh, than an ambulance. But more importantly, the whole commercial, it creates, you know, when one person falls down and the er and the visits and comes on and so forth. And then the second part of this was, again, going back to the onsite guardian, was, uh, uh, this company, thankfully, if they have had a growth, they have had, I think they.
FD: They hire a lot of new people, and we've been able to basically take care of all this new hires, you know, all the OSHA Requirements that they need to check the physical and so forth. It's really a Partnership that is being created to a [00:40:00] provide the employees a Uh, with the highest quality and ease of access at the most efficient rate and also plug in the other holes that is draining the productivity of the company that so much relies on it[c].
Mike Morris: Yeah, I, I, I can't tell you right now, probably more than any time in my career, uh, absenteeism. And we have a relatively low absenteeism rate comparatively, but we don't have a lot of excess, uh, employment in this day and age. So when somebody is off work many times, we can't find somebody to fill that spot because either we don't have enough people qualified that are off that can come in and do that or move up the chain to fill that job to fill behind.
Mike Morris: So, At times, we don't even run an operation for an eight hour shift because [00:41:00] somebody reported off due to illness. So, um, anything you can do to keep people, uh, at the plant during their scheduled shifts, uh, is, is critical to any operation without a doubt. we've had on two occasions, uh, I believe, uh, maybe more, but I know of two, uh, where an ambulance call was avoided because we had the [00:42:00] presence of medical care here. So that, that, uh, and all those things are difficult to capture, but what you do know is fundamentally. It's right, and it's in the right direction.
Josh Taylor: Yeah, and it's about making sure that your team is completely surrounded. Whether they're, uh, having the service so they don't have to come in if it's on the weekend. They don't have to go see the doctor, they can call the doctor whenever. And if they are there, they don't have to worry about having to get up and drive somewhere else.
Josh Taylor: They can actually see someone there. And then make the determination if someplace else is needed.
Mike Morris: And I think the other thing, as I just sit here and reflect for a minute, um, one of the, the selling points for us to change again and move to the guardianship of the bow tie is I'm on this program, me personally, so it's not that the lowest level person is on this and the highest level person is not.
Mike Morris: We're not Congress here. Uh, we, we are, I am on the plan. My family is on the [00:43:00] plan. And I can tell you just from my own productivity. So when I would do my annuals or, or I would, um, you know, catch, catch, catch some kind of illness, I would have to make an appointment with my doctor. I would many times have to take two or three hours away from the office to go visit the physician.
Mike Morris: Um, and yes, we were starting, uh, before we had engaged with the guardian of bow tie online, but we were in its infancy stages with that again takes time. But now it's for me, it's as easy as Calling the, the, uh, the representative here. When do you have time for my annual blood work, my annual this, or Hey, you know what, I've got a little bit of the sniffles when's an opening to come over and see you.
Mike Morris: So I'm probably on my own world. I'm probably saving. eight to ten hours a year that doesn't take me away from my responsibilities here.
FD: Well, I want to thank you, Mike, for your time as a part of the time saving. This was honestly invaluable. I think hearing your Independent voice. Your [00:46:00] assessment. Very, very objective. Very realistic. Uh, very fair. Uh, it's, uh, it's really is one of those again, heartwarming moments of my life that you feel that you've done the right things when you have partnered with the right group and right person.
FD: Thank you so much.
FD: I'm likewise, I think, and looking forward to that future.
Josh Taylor: Thanks, Mike, for the time.
FD: Thank you so much. Good to see you. Thank [00:47:00] you.
[a]Delete the pause after 6:43
[b]Possibly needs an extra second of pause in this edit
[c]clean up the pause between FD and Mike