On Wisconsin Healthcare: Employers as Catalysts for Healthcare Reform
By Curt Kubiak, President and CEO
What if the biggest barrier to fixing healthcare isn’t the system itself but the friction within it?
In The Catalyst, Jonah Berger explores how meaningful change doesn’t come from pushing harder, but from removing the obstacles that stop people from moving forward. This insight is particularly relevant to healthcare, where all parties often find themselves stuck in a system that rewards complexity over clarity and value.
Employers, providers, and patients are frustrated by increasing costs, confusion, and inaccessibility in healthcare. Antagonizing “the other side” has gotten us nowhere. If we want a different outcome, we need a different approach, one that addresses friction, not blame.
Berger identifies five barriers that block change: Reactance, Endowment, Distance, Uncertainty, and Corroborating Evidence. These aren’t just abstract ideas; they’re real forces that keep healthcare stuck in outdated models that don’t serve anyone well.
Employers have a unique opportunity to reshape employee behavior and partner with providers to remove barriers to healthcare through the REDUCE framework. And when employers drive these changes at scale, they help shift the healthcare system itself, moving us closer to a market where value increases, and costs finally trend downward.
- Reactance: When people feel pushed, they resist. In healthcare, that resistance can show up as employees being skeptical of new benefit designs, opting for familiar but higher-cost choices or providers may push back when cost discussions feel like criticism, not collaboration.
- Endowment: People tend to stick with what they know. Employees often default to the same providers or care patterns simply because they’re familiar, even if those choices cost more or offer less value. Providers continue with a fee-for-service model because it’s familiar, and external factors prevent change.
- Distance: Change can feel abstract. Concepts like high-value healthcare or bundled pricing may feel removed from real-life choices. Without clear, accessible guidance, employees will struggle to see how to apply these ideas in real life, like deciding where to get an MRI. Similarly, concepts like value-based care or direct primary models may feel disconnected from day-to-day decisions for providers.
- Uncertainty: Fear of making the wrong choice can be paralyzing. Employees may worry that a lower-cost provider means lower quality, or that trying something new might backfire. Providers fear changing their business model without support will have negative outcomes. This uncertainty leads people to stay in old habits, even when better options are available.
- Corroborating Evidence: People are more likely to change their behavior when they see proof. Shifting long-standing habits requires showing employers, employees, and providers that better, more affordable options exist, and that change is worth it.
Resistance often does not come from a place of unwillingness. It’s often a combination of a lack of understanding, lack of support, or external constraints that make change feel impossible. Sometimes it’s not that someone doesn’t want to change; it’s that they can’t without the right structures and relationships in place.
Removing barriers is the key to changing behavior and bending the medical cost trend. This is where employers and providers must work together. We need two willing parties and the opportunity for change to happen.
What Can You Do?
If you’re an employer, you have more influence than you think. You can:
- Reexamine your processes and assess if they drive value for your organization. If not, make incremental changes and clearly communicate them.
- Invest in educational resources to remove the barrier of lack of understanding.
- Facilitate and promote transparency within your organization and with your benefit partners.
- Collaborate with other employers, providers, and stakeholders to share insights and strategies.
The Catalyst reminds us that meaningful change happens when we remove what’s in the way. If we act together, we can be the catalysts who finally bend the medical cost trend.
What will you do to be a catalyst for change? I’d love to hear from you. Contact me at OnWisconsinHealthcare@the-alliance.org.
Curt Kubiak is the President and CEO of The Alliance, a non-for-profit cooperative that helps employers save money on their healthcare spend. After an early career in the manufacturing sector, Kubiak has spent nearly two decades as an executive in the healthcare industry in Wisconsin.
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