For years, I worked with clients on a broad range of human resource and benefits needs, plus health care specific client work for providers, payors and vendors. Certainly in the United States, the cost and complexity of health insurance has been issue #1 for clients. However, I would spend a lot of time and effort really understanding my clients, their businesses, their labor needs - and frequently come up with a number of recommendations that would promptly be shot down: "we don't have the staff, the budget, the culture! Just go beat up the health plan. I want the same plan for 10% less."
Give me great results without much effort on our part.
That's not how great results are achieved.
As a serious cyclist and recreational bike racer, I know that great results come from hard effort and a lot of work. I founded Threshold Range Consulting based on the cycling (or running - any aerobic sport) that the threshold range of exertion before going anaerobic takes a lot of effort, but is sustainable and produces better training results.
Our work is innovative but may require a lot of effort on your part. It may require taking risks or spending money to save money. It may require cultural changes. If you simply want the basics, there are thousands of people out there willing to get paid to do the basics. I'm going to challenge you, but the results speak for themselves.
That's Me - Cyclocross Race
About Us
CONSULTING EXPERIENCE
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14 Years of experience in global consulting firms: Towers Perrin (twice!), The Wyatt Company/Watson Wyatt Worldwide, and KPMG's consulting organizations
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Involved in a number of notable, forward thinking efforts:
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First efforts to develop Pharmacy Benefit Manager (PBM) analytical tools supporting Towers Perrin's first pharmacist
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Towers Perrin's first relational database for claims analysis, MedManager
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Developing Towers Perrin's first comprehensive health strategy for Delta Air Lines
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Direct contracting with 3 local hospitals in Columbus, GA for AFLAC, the largest private employer in the area
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Watson Wyatt's Comparison tool, allowing clients to compare their benefits to competitors on an actuarial basis
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Branching out into working with health care providers, most notably Columbia HCA and their risk based reimbursement contracts
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KPMG's white paper on Consumerism in Healthcare - a foundational argument for more consumerism in health plans and ideas such as Health Savings Accounts
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Lead integration efforts of Aetna and Prudential's health and dental business
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Advising early stage consumer driven health plans long before the large BUCA plans entered the business
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Developing a coalition approach to purchasing stop-loss reinsurance for self-insured employers
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Consulting work focused on health and welfare benefits for employers, health care provider contracting, health plan initiatives and M&A integration, and broad HR advisory
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Clients included Delta Air Lines, SunTrust Bank, UPS, FedEx, The University of Georgia system, Ford, Nissan, BMW, BF Goodrich, Vanderbilt University (my alma mater!), The State of Ohio, CalPERS, Guilford County (NC), State Street Bank, the US Department of Defense, Blue Cross Blue Shield plans in Florida, Massachusetts, and Georgia, Aetna, Siemens, Hitachi, NYU Medical Center and IBM
MIDDLE MARKET BROKERAGE
After my second time at Towers Perrin, I pivoted a bit to middle market brokerage in Boston with The Bostonian Group (now part of Marsh McLennan Agency (MMA) and William Gallagher Associates (now part of Arthur J Gallagher, aka "Gallagher").
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At Bostonian, I co-lead the larger client segment and managed a number of mid-level consultants and junior analysts while setting the direction of the practice, training our people, reading and advising on the Affordable Care Act as it was passed while I was there, leading new initiatives and being the senior client contact for 25+ clients, including Akamai Technologies, CSN Stores (now Wayfair), Catholic Charities and Pegasystems. Many of our clients were either in high tech or not-for-profits, so also established client groups and service focus in those industries.
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At Gallagher, I created a Subject Matter Expert role for myself around health strategies and engagement while also being a senior client advisor to a number of larger clients, including UMass Memorial Health System and CDM Smith. Developed partnerships with various vendors to help meet their evolving health needs
IRON MOUNTAIN - Employer Benefits Leadership
In late 2012, a former client of mine who was the VP, Total Rewards at Iron Mountain asked me to lunch. He wanted me to come lead employee benefits at Iron Mountain. I hadn't considered going to a corporate role, but leadership was open to ideas and after years of presenting ideas to clients that they dismissed, it was a chance to own my ideas and prove they would work.
By any metric, Iron Mountain's US health plan was a mess: very high per employee and per member costs, average annual trend of 10.8% over the prior 8 years, unhappy employees. In my first 90 days, I met with so many people, analyzed all the data I could get my hands on, identified so many issues, drafted a plan, "socialized" it with numerous management members, presented a final version to the senior executive team, and with their blessing, implemented the first, multi-year strategic benefit plan at Iron Mountain with 10 strategic components and 14 tactical focus areas. We exceeded even our most optimistic projections, delivering $71 million in savings and average trend of 1.6% (including 2 flat years) over the following 5 years.
In addition to the health strategy, implemented numerous 401(k) changes and improvements, new paid leave programs, including a transitional policy for recent mothers returning to work, revamped paid vacation policies and new technologies to support benefits administration and communications.
I was also responsible for Canada and implemented numerous RRSP improvements, a new flex plan and a new wellness program. I took over benefits in the UK and made a number of improvements there while migrating the team to more of a Center of Expertise to support over 50 countries.
Iron Mountain was also highly acquisitive while I was there, and I was part of the core due diligence team on potential acquisitions and had a significant role in the acquisition and integration of Iron Mountain's largest global competitor, Recall.
NEW ENGLAND QUALITY CARE ALLIANCE (NEQCA)
From 2013 through 2018, I served on the Board of Directors of the second largest Accountable Care Organization (ACO) in New England: the New England Quality Care Alliance. NEQCA is the risk bearing entity for 5 hospitals and 1,900 mostly independent physicians, treating over 230,000 commercial, Medicare and Medicaid patients through value, quality based contracts from every health plan operating in Massachusetts. I was one of two non-physician, non-hospital board members, chaired the Compensation Committee and was on the Strategy Committee. I found it fascinating to see how providers responded to the drive to value in many positive ways, and became convinced that one part of the solution for our system is to base reimbursements on the quality of care, not just the quantity.
THRESHOLD RANGE CONSULTING
After almost 6 years at Iron Mountain, I was on my third manager in less than a year who decided she wanted someone else leading benefits. Many of us have been there. So, I began my solo consulting practice, recognizing that an experienced professional with experience in health plans, large employer consulting, middle market brokerage, innovation groups, corporate benefits leadership and embracing innovative solutions could add value to a lot of different situations.
SS&C TECHNOLOGIES - Contract Global Benefits Leader
In October 2019, I was approached by contacts at Aon about their client SS&C who desperately needed a benefits leader due to an acquisition and US open enrollment. What began as a 3 month gig turned into 15 months as I supported them through 8 more acquisitions, mostly outside the US, and a North American Workday implementation. During this time, I managed a team of 7 people in 4 cities, supported Canada on both RRSP and benefit improvements, implemented group benefits in Mexico, oversaw harmonization in Singapore and got them through open enrollment for 2021.
