20-40%

Typical Total Cost Savings Identified

20-40%

Typical Total Cost Savings Identified

20-40%

Typical Total Cost Savings Identified

Why Legacy Healthcare Models Fail CFOs

Legacy BUCA healthcare arrangements were not built with your financial interests in mind. Every component of the traditional model — the carrier, the broker, the PBM, the TPA — profits from higher spending, not lower. The result is a system that functions exactly as it was designed to function.

• Annual renewals with predictable increases
• Opaque pricing and multiple hidden compensation streams
• Egregious pharmacy cost escalation
• Claims overpayment, overcharging, waste, and abuse
• No vendor accountability — unchecked profiteering
• No measurable governance process
• Rising employee dissatisfaction
• Cost shifting as the primary employer cost reduction strategy

The result: healthcare becomes a growing drag on margins, cash flow, and planning confidence — with no structural path to improvement inside the legacy model.

Introducing a Better Standard

It is a custom-crafted, fully integrated healthcare governance and risk management platform — the first of its kind — built to replace fragmented legacy healthcare financing with a CFO-focused system centered on transparency, actuarial discipline, risk management, and measurable financial outcomes.

Unlike legacy healthcare models built around insurance carriers, brokers, PBMs, and disconnected vendors, FiduciaHealth Governance™ creates a unified healthcare financing architecture built on transparency, accountability, actuarial integrity, and long-term financial sustainability.

Our platform integrates stop-loss, network access, PBM management, reinsurance, administrative infrastructure, compliance oversight, and specific-needs risk management into a single governance-based solution aligned with the actuarial and financial objectives of modern CFOs.

Healthcare is no longer just an HR issue — it is one of the largest unmanaged financial exposures on the balance sheet.

The CFO FiduciaHealth Governance™ Framework

A modern executive framework built to deliver transparency, accountability, and measurable financial performance across your entire healthcare supply chain.

Financial Diagnostics — Total spend analysis, trend review, claims leakage detection, and pharmacy cost review — built from your actual 24 months of claims data, not industry averages.

Vendor Economics Review — Identification of hidden fees, multiple revenue streams, and misaligned incentives embedded in your current carrier, PBM, and TPA arrangements.

Transparent Market Replacement — Legacy vendors and brokers are replaced with fully vetted, transparent, accountable partners — every component independently selected on merit, not relationship.

Governance Structure — Quarterly oversight, executive reporting cadence, and a documented fiduciary decision process that demonstrates prudent plan management at every stage.

Measured Outcomes — Savings, trend reduction, improved forecasting predictability, and stronger executive control — measured and reported against your baseline.

Built Around What CFOs Actually Care About

Most advisors discuss renewals. We redesign the economics of healthcare spending.

FiduciaHealth Governance™ is designed to deliver against the financial priorities that define executive performance:

• EBITDA Protection — eliminating the hidden vendor waste quietly draining employer profitability
• Cost Containment — up to 30–35% reduction in total healthcare program costs
• Forecast Accuracy — improved cash flow predictability and trend management
• Fiduciary Risk Reduction — documented governance process aligned with ERISA obligations
• Vendor Accountability — performance-based contracts replacing volume-based relationships
• Better Employee Value — what employees describe as the best insurance they've ever had
  

The Least Governed Line Item on the Balance Sheet

Healthcare is typically your second-largest expense after payroll. Yet it is the least governed.

The 2026 industry average employer healthcare cost is $17,000 per employee per year — and rising. Recent Advanced Benefit Design clients are operating at $11,048 PEPY — a $5,951 per-employee differential. Multiply that by your covered employee count and you have the financial opportunity sitting inside your current plan.

Most companies apply disciplined oversight to every major expense category except healthcare. That gap creates unnecessary cost, weak accountability, and budget volatility. FiduciaHealth Governance™ closes it.

We help CFOs fix it.

Why Advanced Benefit Design Institute

Scott Hettesheimer has spent more than four decades developing the Advanced Benefit Design framework and the FiduciaHealth Governance™ model. His practice operates under a single governing principle: every dollar left inside a legacy carrier arrangement is a dollar the employer funded without knowing it existed.

Advanced Benefit Design Institute is independent, strategic, and built specifically for leadership teams seeking measurable, documented outcomes — not managed renewals.

Healthcare is too expensive to manage without governance.

Stop Renewing. Start Governing.