Expert Interview: Braden Monaco

April 02 2019 / by Mari Ryan

In this Expert Interview, AdvancingWellness CEO Mari Ryan and Braden Monaco explore employer strategies for managing health care costs. Braden is a managing partner at Blue Horizon Benefits, a privately-held concierge-style consulting firm.


Braden Monaco Interview

Mari Ryan: Welcome to the Workplace Wellbeing Essentials Series. I'm Mari Ryan, I'm the CEO and founder of Advancing Wellness. It's my pleasure to welcome you today to this expert interview, where we explore topics that impact employee wellbeing. My guest today is Braden Monaco.

Braden is a managing partner at Blue Horizon Benefits, a privately-held concierge-style consulting firm based north of Boston, Massachusetts. As a client-centric approach and open dynamic collaboration have been at the forefront of what drives Blue Horizon’s success. Blue Horizons is a true partner. Welcome, Braden!

Braden Monaco: Thanks, Mari, glad to be here.

Mari Ryan: My pleasure to have you here today. Today we are going to explore the topic of employer strategies for managing healthcare costs. As we know, healthcare costs have been a topic, and healthcare costs reductions had been a topic for years that have often been the goal of workplace well-being programs. Unfortunately, that goals has not always been achieved. In today’s expert interview, we are going to explore some of these employer strategies for managing healthcare costs. We know that in the U.S., we live in an employer-funded healthcare model, and we also know that’s not changing, that’s kind of here to stay. We know that medical cost inflation runs at about five percent annually. Employers need strategies to help manage these costs, even just to stay even on these costs. Braden, I’m curious, how can employers look at their costs to understand and manage them?

Braden Monaco: Absolutely, it’s a great question, I think, about managing healthcare costs, I think that there’s a few things that employers need to look deeply at. I look at healthcare no different than any other area of their business. I work with a lot of construction companies, blue collar organizations, and they are looking at their supply chain in so many different ways. They are looking at where a product is coming from, where a product is going, they’re looking at time-labor, they are looking at so many different pieces of those business units to make sure they maintain profitability.

When it comes down to healthcare, I don’t think that is something a lot of employers are doing. When it comes down to looking at healthcare as a business unit, it’s hard to have that conversation with employers because they just want to run from the healthcare conversation in general. So, it’s been a very reactive conversation for years. When we talk to our clients or perspective clients, the annual process is very reactive. What is our increase this year, what do we have to do to mitigate it, they make a decision, educate employees, and move forward.

I think employers these days have to understand there is a lot more that drives the healthcare train than just an insurance company giving you a rate. Understanding the analytics, the data that goes behind it, is very important to making decisions. It is no different than any other area of their business.

Mari Ryan: It’s interesting, that’s been my experience that I’m always asking clients to delve in a little bit deeper and understand a little bit more, and somehow they just don’t seem to want to do that.

Braden Monaco: They are really not interested. I understand it, I understand as a business owner, as a leader of an organization, your main focus is profitability and growth in the area of your business that you specialize in. We all that things that we are good at in our organization, and we all have things that we tend to want to run away from and hand off to somebody else. I think that’s why it’s become more important to start work with a partner, like us, maybe, to analyze that and have someone who is going to have your best interest at heart.

But, you’re right. The owners don’t want to dive in. I think it’s the fear of the unknown, maybe change is on the horizon when they dive in further, or in some instances, honestly, if the economy is going well they don’t even want to take the time to do it because taking the time to do it can have a large – or, making any change can have a large impact on the organization moving forward as well.

Mari Ryan: Understand. So, you mentioned understanding this in a little more detail. What role do analytics play in understanding healthcare costs?

Braden Monaco: If you can get your hands on them, which is one of the battles you have, especially here in Massachusetts. Any group under one hundred, we are very limited as to the amount of data that we can get from the insurance carrier themselves. Analytics play a huge factor in understanding what is driving your healthcare costs. If you don’t understand the nuts and bolts of what is going on under the hood of your health plan, it’s hard to make decisions moving forward that are both in the organization’s best interest, as well as the employees.

So, when you look at analytics, it’s important to think outside the box and figure out ways in which you can gain some more data, more insight, because as you know, data can drive decisions. It’s something we internally take seriously, is trying to gain as much data as we can, whether that is through medical questionnaires to employees anonymously to understand what is going on with each person so we can help design a better plan for them.

Oftentimes when you gain this data, you understand your annual per employee per year costs. You can start to make decisions and choices that are actually in the best interest of your employees and for their wellbeing. In turn, a lot of times that can actually decrease your costs because you are building a health plan specific to what your data is telling you.

Mari Ryan: That’s great. I’m curious about how you help employers understand the value of healthcare?

Braden Monaco: That’s a loaded question, a loaded pistol at times. I think everybody looks a value in a different way. I think that value is something that we can look at in every area of our lives, when we want to buy a car, Car A versus Car B, what is important to us as a consumer. When we’re buying a computer or we’re buying cell phones, everybody has value in a different way.

When it comes to healthcare, I don’t think employers are diving into the understanding of what is important to them, what is important to their employees. In some companies, it’s very cost conscious, and in other companies it’s not as cost conscious and the level of benefit is more important.

When we look at value as an equation of cost over quality, you can understand what we are paying today for what are we getting, and that can equate to value. We’ll pay less for a higher deductible plan. Maybe that’s value to us because we have a young and healthy staff, or we want to have a first dollar benefit coverage plan because we have a high wage earner organization that we are fighting for labor, we are having trouble finding and recruiting talent, yet alone keeping them and retaining that talent.

I think one of the major questions that we ask our clients is understanding their culture. Culture drives value. Once we figure out your culture, we understand your value, then we can start to design your health plan according to those two factors.

Mari Ryan: Fabulous, that’s great. I’m wondering if you see in how the market is changing if the role of the broker consultant is changing in today’s market place.

Braden Monaco: Yeah, I think I touched upon that briefly a moment ago; I think our role for so many years, and we shy away from the term “broker,” the term broker for me is nothing more than somebody sitting in between two parties, moving information back and forth. At the end of the day, our system in general, with … I’ll just use Massachusetts, but across the country is broken in regard to who pays us. We get compensated by, traditionally by the health insurance company on behalf of our client. Indirectly our client is paying us through their premium. That’s not something that is often discussed in open collaboration with your client, so transparency is really important.

To the root of that question, I think it comes down to working with someone that is going to have your best interest at heart and align their mission with yours the entire way through. So, we look at it and say we sit on the same side of the table as our clients. It is our job to make sure we are working in the best interests of our clients. The fiduciary word hasn’t fully come into our industry yet, but if it was here, that’s how we want to operate. I think that’s the role of a consultant. A broker is just moving information; a broker is just a middle man between two different parties. Our goal, again, is to make sure that we are looking after our clients’ best interests on a daily basis, understanding their needs, and delivering tools and resources and products to them that fulfill those needs.

Mari Ryan: That’s great. It sounds like you certainly do have a much higher touch, higher type of collaboration type of approach.

Braden Monaco: Absolutely, it’s really important to me to make sure that our … I say this all the time, in any industry it’s really hard to earn new business. It’s hard to get someone to trust you enough to open up their doors, open up their wallet in so many instances to work with you. For us on the back side, making sure everyday we are doing something new, innovative, creative, understanding what is going on in the industry across the country, how it may impact our local market, and I think that’s where you start to go back to that value proposition as well. When I look at value, what value do we bring to our customers and our clients, and I think that’s where our clients start to see when we deliver value to them, they start to understand that everything we try to do is turning off of that value equation.

Mari Ryan: That’s great, I appreciate that approach. If our audience wants to learn a little bit more about you and the work that you are doing, where can they find you?

Braden Monaco: Absolutely, that would be great. They can reach us, reach me at, or they can check out our website at

Mari Ryan: Fabulous, thanks so much for being here today, Braden. I appreciate your insights.

Braden Monaco: Thank you for having me, this was excellent.

[End of audio]

Topics: Worksite Wellness, Wellbeing, worksite wellbeing, workplace wellbeing, wellness, employee wellness, worksite well-being, employee benefits, hr, employee well-being, human resources, corporate wellness, healthcare costs

Mari Ryan

Written by Mari Ryan

Mari Ryan is the CEO/founder of AdvancingWellness and is a recognized expert in the field of workplace well-being strategy.