Healthcare Rebel Alliance: Q&A with Matt Ohrt, Self Fund Health

Nick Soman, Decent‍

How did you get into healthcare, and why did you start Self Fund Health?

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Matt Ohrt, Self Fund Health

You might say, I got into healthcare by accident (pun intended).  For the first two-thirds of my nearly 25 year HR career, I saw healthcare as mostly boring and untouchable.  I thought that “a claim, was a claim, was a claim”, and that costs were solely determined by whether members on the health plan got ill or injured.  I viewed the healthcare industry as one of integrity.  I trusted my broker. 
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I was wrong on all accounts.  I dabbled a little in 2012 with a Fortune 500 employer by putting an NP onsite (a direct hire) to lead our wellness program, which would eventually win the American Heart Association’s Platinum award two years in a row, but candidly, the focus was more on culture development and achieving a “great place to work” status, more than it was about health plan cost or healthcare.  A few years later, my career would take an unexpected and very interesting turn.  
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In 2016, I joined Merrill Steel as the VP of HR.  Almost immediately after starting, I got to know Karen Rajek very well.  She was the sister of three second-generation sibling owners.  We would talk frequently, sometimes for a few hours at a time, about unrealized dreams and unsolved problems that had been discussed for years.  In one of these conversations, she shared that they had been experiencing 9-10% compounded increases in health plan costs for the past five years.  She said they had been absorbing the costs to protect employees and their families, but that it was becoming too much and they couldn’t continue to do it.  She asked if I knew of anything that we could do.  
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We continued to collaborate and shortly thereafter, we had a plan in place to take our first step of starting an onsite clinic - the Merrill Steel Family Clinic.  We promoted it in all the ways we could think of and it didn’t take very long before many employees and their family members began using it.  After the first quarterly financials closed, we learned that the clinic had already achieved an ROI.  We continued by installing a 480 plug so we could facilitate onsite MRI’s.  Next, I traveled with the President to Illinois to buy a used ambulance.  We wrapped it and it became our mobile clinic and rolling billboard for recruiting.  We had two ambulances to choose from.  One was from Chicago said “no guns” on the dashboard and the other was from Iowa.  It said “no smoking”.  We chose the one from Iowa.  It was 20 years old but in like new condition.  Every step we took had a notable ROI on our investment.  We weren’t just picking low-hanging fruit, we were tripping over it – and we were on to something.  
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While we had taken some good initial steps, we hadn’t changed our health plan design and we hadn’t analyzed or changed our partners yet.  Then something very unexpected happened.  
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On a Saturday morning, I had a near-death experience at my home.  I was run over by a 4,000 lb. tractor, which then rolled into the Wisconsin River.  I should have died, but somehow I lived.  My subsequent medical and billing experiences were both unsettling.  They disturbed my soul.  Once I was back to work, they motivated me to push forward even harder and do the “impossible” work to completely transform our approach to healthcare and how we managed our health plan.  They didn’t feel impossible to me, but everyone I talked with reminded me of their opinion.  Thankfully, I didn’t listen to them.  
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We achieved many great things and our success attracted a lot of attention.  We saved the plan and the members millions of dollars, and we greatly increased the accessibility and quality of care.  This led to many awards and the founding of the Healthcare Best Practice Group.  The group had 1200 people this past summer and it is growing fast. It now has over 3200 people!  
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Through this experience, I saw an opportunity to help all Wisconsin employers fix their healthcare.   I joined Jon Baran and together, we cofounded Self Fund Health.  Self Fund Health is an employer-designed, employer-proven health plan that is modeled after the one I built at Merrill Steel.  We have a continuous improvement mindset and we never stop tweaking the dials and calibrating the levers to make it the best it can be.  We aim to help all employers do “the impossible” and change their health cost trendsfrom unsustainable to sustainable.  In July of 2023, I released a book I had written called, Save Your Company: Don’t Feed the Beast – The Employer Healthcare Success Formula and almost immediately, it went national. This book is a guide for employers, forward-thinking advisors, doctors, and all others who desire free market healthcare.  It has given me a platform to share the good news of how we did it on healthcare conference and event stages all across the nation.

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Nick Soman, Decent

What's the relationship you see between work culture and work results?

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Matt Ohrt, Self Fund Health

I see a direct relationship between these two things.  So many people, it seems, don’t see a relationship at all.  Culture is not just a fluff topic.  It is a tangible thing and it is a company’s best advantage in thecompetitive marketplace.  A high performing culture is not easily obtained.  It requires talented and humble leadership.  I used to joke around, saying, “HR would be easy if it weren’t for the people”. The same applies to leadership.  People are complicated, messy, and unpredictable.  People also have amazing potential and people are ultimately the difference between good and great companies.  Attract the best people, retain the best people, and get them rowing in the same direction and amazing things can happen.  
  

Peter Drucker once said, “Culture eats strategy for breakfast”.  I agree with Peter.  What good is a strategy if no one pays any attention to it or invests their heart and soul to carry it out?  Answer – it is mostly worthless.  So many seem to misunderstand this concept.  I would argue that literally half – 50% of the leadership challenge is to lead a group of people from A to B. To be a transformational leader – it is important to influence a group of people to detach from a broken, antiquated way - to a better way.  It can be bumpy – it can be like walking through the desert, and it can be especially lonely for the leader.  The leader starts out alone on this conquest, with nothing but a dream and a vision, and slowly and steadily he or she gains a following that creates momentum - and movement.  
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How does a leader shape a culture?  It’s not what we say, as much as what we do.  If our actions don’t match our words, ironically, we are creating a culture in which hypocrisy is expected and accepted, and we certainly haven’t gained the respect and following of the team.  People know almost instinctively if a leader truly cares about them and if the leader is truly invested in their lives – versus just manipulating them for business or personal success.  While many try to act as if they care, they fail, because this simply cannot be faked.   
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I am not a fan of everything Jack Welch, former CEO of GE, said and did, but it is my opinion he got one thing right.  He said that leadership is not about the leader.  Specifically, he said, “It’s not about you.  It’s about the people you are leading”.  The people we are leading don’t feel sorry for the leader or lose any sleep when they see that the leader is stressed or overwhelmed.  They see the leader as having the privileges and making the “big bucks”.  As leaders, we need to “get over ourselves” and make it about the cause.  People will wholeheartedly follow a just cause or purpose.  

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Nick Soman, Decent

What are the best and worst things about your job?

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Matt Ohrt, Self Fund Health

The best thing about my current role is that I get to help others. This is my root passion and it is what gets me out of bed. I get to help companies find a sustainable path with their health plan, and I get to help their employees and their families find affordable or free care to ensure good health and prevent bankruptcy.  I also enable patient flow for independent physicians so that they are able to sustain and thrive in their practices.   
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The worst thing about my current role is that there is a strong and still dominant contingent, who many affectionally call the status quo healthcare industry, that has dug in its heels and is resisting necessary change.  I have found that the healthcare industry’s norms of ethics, cronyism, and bribed-fill compensation are toxic, as compared with other industries.  In some sense, this industry is filled with normal everyday folks - many of them are friends or colleagues of mine.  They simply have adopted the culture they joined.  
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However, at a larger scale, the business models of the status quo healthcare industry are built on paying or receiving side commissions, and due to the exponential cost employers are experiencing, their business model has become antiquated and it is no longer sustainable. Interestingly, they do not accept this fact, and it is as if they are driving toward a cliff, continuing to play the old games that worked for them 20 years ago - but instead of pumping the brakes, they are looking out the side window at the scenery and pretending everything is fine, hoping that fate will somehow change their mortal path.  Employers must wake up and begin to manage their health plans, as they do other areas of the business. They must change their mindset to purchase healthcare, instead of purchasing insurance.  They must see through the deception of the industry.
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9 out of 10 employers think they have trustworthy, strategic partners, and in reality, 9 out of 10 have untrustworthy, status quo partners who are posing as the former.  It is not uncommon for employers to change from one untrustworthy partner to another untrustworthy partner.  When employers eventually stop delegating the management of their health plan to the sellers, and take it back - the market will shift astronomically.  

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Nick Soman, Decent

What misconceptions about Human Resources would you like to clear up?

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Matt Ohrt, Self Fund Health

Having worked in Human Resources for nearly 25 years, I must share that I have always been a littlefrustrated with some of my colleagues - not because they aren’t great people.  They are.  Rather, because the majority of HR folks seem to be “change avoidant” or even “change resistant”- unexplainably willing to watch things degrade slowly and to try to please people for the moment rather than doing the harder work to fix the root causes of problems.   In the realm of healthcare, many HR professionals have had a goal to “keep em’ happy”.  This is in contrast to taking a stance and doing what is right to make sure things are better for the long term.  With healthcare, for instance, 20 years of acquiescence and failing to manage the health plan as a key part of the business has broken the trust with employees - it has burned out the trust candle to the point that everyone has given up on the expectation of having affordable or accessible healthcare.  They don’t even bother to speak up anymore, and this creates the false impression in enrollment meetings that things are ok.  They are far from ok.  They are utterly broken.  
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HR leaders have a great opportunity to step into this realm.  There is so much opportunity to improve.  They can be a hero with their CEO and their employees if they are willing to try.  For most, the industry has completely bamboozled them.  The BUCA’s sponsor their annual HR conferences, and status quo brokers speak on topics outside of their expertise, such as recruiting, retention, workplace culture, and the like, in order to draw big audiences and to get in front of HR professionals, with a surreptitious goal to become their broker of benefits.  Don’t fall for the deception and the tricks.  In my book, I explain my journey of discerning the trustworthiness of partners and making the necessary changes to fix these issues.  

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Nick Soman, Decent

Who else in healthcare inspires you, and why?

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Matt Ohrt, Self Fund Health

Marty Makary inspired me early in my journey.  While the solutions discussed in the last chapter that cover the last half of the book’s title – How We Can Fix it, are extremely brief and mostly not beneficial for those sitting in employer chairs,  I found the descriptions of the problems to be second to none. He opened my eyes and fueled my passion to keep going.  If you read the chapter titled “Carlsbad”, and it doesn’t stir your soul, I will buy you a chicken dinner.
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John Torinus was an early inspiration.  He was a fellow employer and a true pioneer to show that it could be done.  He wrote the first book of how to succeed - from an employer's perspective, and I wrote the second.  These are the only two books of their kind in existence, to my knowledge.