Impact Employee Benefit Strategies

Why I can’t leave this alone

I could sell insurance and sleep fine. I can’t do it.

The greatest asset a human being has is the ability to stay healthy, stay productive, and live a decent life.

That is not a slogan somebody printed on a mug for me. It is the reason I get up. For 38 years I have watched employers pay a fortune for a health plan and then stand back while their people got sicker. The science on what works was settled years ago. Not using it is a choice somebody made once, and nobody has questioned it since.

There’s a thing astronauts describe when they come back from orbit. You can’t see any of the borders from up there. The whole thing is obviously one connected system. They call it the overview effect. Healthcare works the same way, and almost nobody looks at it from that altitude. Everyone tends their own piece, and the person whose body all of it is about is the only one in the room without a seat.

I want that person to have the seat. This is in my DNA, and it’s how I plan to work until I retire. Or die, if it kills me.

Pat Reilly — 38 years in employee benefits, and still irritated about it

Worth ten minutes of your time: Overview, the short documentary directed by Guy Reid at Planetary Collective, with Apollo 14’s Edgar Mitchell, Ron Garan, Nicole Stott and Frank White, who wrote the book the idea comes from. It has nothing to do with health insurance and everything to do with why I think about it the way I do.

The vision

A health plan your people would actually thank you for.

Here is the picture I’m working toward, one employer at a time. None of it is science fiction. All of it is running somewhere today.

Seeing a doctor costs nothing

No copay and no deductible standing in the doorway. People go early, while it’s a $200 problem and not a $45,000 one.

Somebody knows their name

A nurse in the room, not a portal nobody logs into. People already know what they should be doing. Another human being is what gets them to do it.

The waste pays for all of it

No new line in your budget. What you’re overpaying hospitals and drug middlemen today covers the whole thing.

Your people don’t believe you care because you said so. They believe what you spent money on when you didn’t have to. Start there and the cost follows. Start with the cost and you get what the wellness industry has delivered for twenty years: a website nobody visits.

What I’ve built

This isn’t a theory. I built it, and it’s running.

You shouldn’t have to take any of this on faith. Here is what it has already done for real employers and real people.

I co-founded PeopleOne Health.

It is primary care built for employers: unlimited visits and nothing due at the counter, so people actually go, and the big claims stop showing up. In 2024 Google Ventures led a $32.3 million round to grow it. Today it is opening health centers across Florida, and PeopleOne reports that members score it above 90 on the standard would-you-recommend-this survey, where healthcare as a whole averages about 35.

Real employers put their people in it, and real investors put their money behind it. What that means for you: nothing I’d bring to your plan is an experiment. It has already been tried on thousands of people.

See PeopleOne Health →

Ten years. No rate increase.

One of my districts hasn’t taken a health plan increase in about a decade, through a stretch where the rest of the market absorbed seven, eight, nine percent a year. That didn’t come from negotiating harder. It came from rebuilding the plan so the waste stops funding itself.

17 people walked back from a diagnosis.

At that same district, 17 employees started with metabolic syndrome — the cluster of numbers that runs ahead of diabetes, heart attack and stroke. Six weeks later they no longer met the clinical definition of it, and not one of them took a drug to get there. It cost about half a penny out of every health care dollar, and it wasn’t new money. It came out of the waste.

And I’m still building. HomeTeam Health, OptimizeU and the provider network I co-own all come from the same idea: find the money being wasted and spend it on keeping people well. That is exactly why I built every one of them.

Want to know what’s hiding inside your plan?

Have a conversation

The problem

Three ways your health plan picks your pocket.

None of this is a conspiracy. The system works exactly as designed. It just wasn’t designed for the person paying for it.

The chargemaster

Hospitals invent a list price nobody pays, then “discount” it down to three to five times what Medicare pays for the identical service. Your network discount is measured against a number that was made up.

A bag of saline costs about a dollar. It shows up on the bill at $137.

The pharmacy middleman

Your pharmacy benefit manager makes money three ways you can’t see: the spread between what it pays the pharmacy and bills you, the rebates it keeps, and which drugs it decides to put on your list.

Every one of those is a reason for your drug spend to go up, not down.

The access trap

You raise the deductible to hold the premium down. Your employee skips the doctor for eighteen months because a visit costs real money.

Then the thing that was a $200 office visit arrives as a $45,000 claim, and your renewal pays for it.

What most employers are doing

Fully insured, or self-funded without the data
Paying 300–500% of Medicare on facility claims
A pharmacy manager keeping rebates you never see
Employees avoiding care to protect their own wallet
Double-digit renewals, every year, forever

What my clients do instead

Self-funded, owning their own claims data
Paying hospitals a defined multiple of Medicare
A pass-through pharmacy arrangement — rebates stay with the plan
Primary care with nothing at the counter, so people actually go
Money recovered from waste, spent on keeping people well

How I do it

Plans that cost less and actually get used.

Four mechanisms. None of them are exotic. Each one takes a cost you’re already paying and puts it to work for your people.

01 — Plan design

Self-funding, done with the data

You own the risk and, more importantly, you own the claims file. Stop-loss coverage handles the catastrophic tail. The difference between this and what you have now is that you can finally see what you’re buying.

02 — Pricing

Reference-based pricing

Stop negotiating a discount off a fictional number. Pay hospitals a defined percentage above what Medicare pays — the same yardstick the federal government uses. Facility claims typically fall by 40% or more.

03 — Access

Direct primary care

Unlimited visits, labs, imaging, behavioral health and most common prescriptions, with nothing due at the counter. A person who pays nothing to see a doctor goes to the doctor. That is the entire mechanism.

04 — Pharmacy

Pass-through pharmacy

What the pharmacy was paid is what the plan is billed. Rebates belong to the plan, not to a middleman. Running live in Pennsylvania school districts right now.

Not sure which of these fits your plan? That’s the first conversation.

Let’s talk

How it connects

Why there are several companies, and what each one does for you.

People ask why there are several companies. The answer is that each one exists because something needed to be built that nobody was going to sell me. They are one idea with several working parts.

IEBS

Impact Employee Benefit Strategies — the plan design. This is where the waste comes out and the money gets found. Everything else is paid for from what this step recovers.

PHS

Preferred Healthcare Systems — the provider network, which I own a third of. Owning it is the point: pricing stops being somebody else’s secret, and the contracts can be built to do what the plan actually needs.

HomeTeam

HomeTeam Health — the delivery side that sits on top of the network. Primary care, pharmacy, reference-based pricing and engagement assembled into something an employee can actually use without a decoder ring.

OptimizeU

OptimizeU — the program I built and run. A finger stick to find out who’s in trouble, six weeks with a nurse who knows their name, and a second finger stick to see what they did with it. This is the part that changes behavior, and behavior is the part nothing else touches.

PeopleOne

PeopleOne Health — the one I co-founded, and where this model was tested at scale. Google Ventures led a $32.3 million funding round behind it in 2024, and it is now growing across Florida.

The HomeTeam Health system — Core Plan, Direct Primary Care, Reference-Based Pricing, RXEnhance, OptimizeU and Direct Contracting

The pieces, assembled. Each one exists because the one before it created the room to pay for it.

In a client’s words

What it looks like when it works.

“Patrick and Maureen possess a rare combination of deep medical plan expertise and a sophisticated understanding of school-based regulations and compliance. They were instrumental in our transition to a self-insured school district, the launch of a district primary care office, and have helped us through multiple union contract healthcare negotiations. In my years of district leadership, I have encountered few professionals who possess such a high level of professionalism and care. I truly do not know what I would do without them.”

Kelly Kessling — Benefits Manager, Central Bucks School District

About

Thirty-eight years, and I still can’t leave it alone.

I started in group insurance at P&A Group in Buffalo and spent 22 years there, going from sales manager to vice president of corporate development and helping build the company nationally. Then I owned a third-party administrator in Georgia, which is where I learned how health plans actually run when nobody is watching.

Today I run Impact Employee Benefit Strategies out of Youngstown, New York, and I’m a partner in Preferred Healthcare Systems with Maureen Frucella and Brian Brumbaugh. I co-founded PeopleOne Health, and I work with school districts, manufacturers, municipalities and mid-market employers in Pennsylvania and beyond.

I wrote The Survival Guide to the Healthcare Apocalypse because I got tired of saying the same things in conference rooms and watching nothing change.

One thing I say out loud to every school client: I’m a paid consultant to you. I’ll tell you where every dollar goes, including mine.

Speaking

Thirty-eight years of war stories, hard numbers and a few uncomfortable truths.

I was faculty for Lorman, teaching continuing education on cafeteria plans, Section 125 and HRAs — sessions that carried credit for HR professionals, attorneys and CPAs.

SHRM chapters, broker trainings, board retreats, school district workshops, and anywhere else people are willing to hear that the renewal letter is not a law of physics.

Book a session

The Survival Guide to the Healthcare Apocalypse

The long version of everything on this page. Find it on Amazon.

Let’s talk

If you’re looking for quotes, any broker will do.

If you want to know how much of your health care budget is going to keep people well instead of cleaning up after them, that’s a different conversation and I’m glad to have it. No pitch deck. No forty-seven slides.

preilly@impactebs.com

Phone

(716) 984-9249

Where

Youngstown, New York

The first conversation is a conversation. I’ll ask what your plan costs, what your renewal looked like, and how much of it went to anything other than paying claims. If the answer is nothing, we’ll both know pretty quickly whether there’s anything here worth your time.