Healthcare and HSAs

Nine years ago, while a third year graduate student at Vanderbilt, Alex Tolbert had an ‘Aha!’ moment.

The concept of Bernard Health came to him while sitting in a class on health law at Vanderbilt Law School. One of the concepts discussed by Professor James Blumstein was a health savings account. Tolbert realized HSAs could help redirect a lot of the misaligned incentives that were taking healthcare coverage in the wrong direction.

When Tolbert arrived in Nashville to earn a graduate degree in a combined JD/MBA program at Vanderbilt, he thought he would move to New York after finishing his education to work for a hedge fund. What got in the way of his carefully crafted life plan was that insight into the healthcare system and the conviction that he could help build a better mousetrap.

Soon after, in June 2006, Bernard Health got its start. Nine months later, Alex was joined at the nascent company by his brother, Brian, who left Cleveland and came to Nashville to help grow the start-up business. The brothers soon realized two things:

many employers do not get the advice they need to provide healthcare coverage to their employees, and

individuals have nowhere to go for a health insurance education and advice.

Tolbert said, “We formed Bernard with the mission to be the world’s most trusted advisor in helping people plan how to pay for both expected and unexpected healthcare expenses.”

The Tolberts realized that what kept employers from succeeding was a plan structure that did not strike the right balance between how much savings to keep versus how much to share with employees. They also saw that using the right terminology and building a strong support system could have a huge impact on helping employees choose to be part of the HSA.

Tolbert said, “We asked, ‘Do you ensure your HSA messaging gets to the spouse? Do you provide effective pricing tools?’” He continued, “The right plan structure that strikes the right balance between employer and employee saving requires excellent communication. The best HSA messaging is important to ensure your people understand how it all works.”

The strategy worked. “We have been building a track record — first-year HSA participation rose to a rate of 82 percent. This is more than 10 times better than industry averages and means significant bottom-line savings for our clients,” Tolbert continued.

He added an important element of the company’s success is the support they offer clients including assigning a Bernard nurse to help employees price-shop their prescriptions and a claims and billing support team that knows how to help employees participate in HSA savings. Knowing how critical communication is, Bernard provides a customizable, web-based video to ensure consistent HSA messaging gets to spouses at home.

“We found that while many employers do not get the advice they need, individuals and families have almost nowhere to go for health insurance advice. We felt that people would like to go into a ‘storefront’ and have face-to-face interaction with experts in designing their plan,” Tolbert said.

The stores allow clients to sit down with a trained advisor to discuss their unique situations. There are now three Bernard locations in the Nashville area (Thompson Lane, Harding Pike and Franklin), as well as storefronts in Indianapolis, Austin and Ohio.

“We look forward to putting down roots across the country with a network of healthcare retail stores where we could ‘rescue you from healthcare confusion,’” he said.

Tolbert said Bernard should have a presence where people could use the most help. “We realized it was a lot more comfortable to advise the patient than the company —that’s our core competency. This is where we’ve had the fastest growth — working to help with patient solutions, and we find that generally what’s best for patient is what is best for providers.”