How many sons-in-law does it take to screw in a lightbulb?

March 18, 2024 / By Clark Cameron

My late father-in-law was a prince of a guy. He was kind, funny, generous and a jack of all trades. His skills included painting, plumbing, electrical, sheetrock, hanging wallpaper and more. He was practically Bob Vila, the American home improvement television show host. So, when my wife married me, she assumed she was getting someone equally as handy around the house. Of course, she was wrong.

Early in our marriage, a bedroom lamp stopped working and my wife asked me to fix it. After several minutes of inspection (checking the cord, the switch, the outlet and even the circuit breaker box), I’d reached the edge of my lighting knowledge and needed a professional to help. Not wanting to confirm any of my father-in-law’s suspicions about my deficiencies, I decided not to call him. I called an electrician instead. When he arrived, I provided a complete rundown of everything I’d tried, pointed him to the back bedroom, and wished him luck. Thirty seconds later the lamp was on and I found him writing an invoice for $57. Before I could voice my obvious question, he blurted out, “Just needed a new light bulb.” Writer’s note: I assumed the sting of this story would be gone after more than 25 years. It’s still too soon.

Famed business management guru Peter Drucker once advised, “Do what you do best and outsource the rest.” This is sound advice for all companies, but especially for health plans. Health insurance carriers are responsible for financing health care costs and coordinating health care services for their members. Drucker also observed, “Even small health care institutions are complex, barely manageable places. Large health care institutions may be the most complex organizations in human history.”

I’ve worked in and around commercial health insurers my entire career and have found that an ethos of ‘built here’ often exists. Whenever possible, most payers want to build rather than buy, and insource rather than outsource. Such thinking eventually leads to antiquated systems and inefficient processes. Although the health insurance industry is highly fragmented, half a dozen strong national players combine to own half the market and have deep enough pockets to maintain the most sophisticated, cutting-edge technology available. The remaining several hundred health plans can’t match the staffing levels or cash reserves of the behemoths, so how could they possibly keep up with novel, value-adding innovations?

They should follow Drucker’s advice and continue executing their core competencies while outsourcing the rest. Over the past 10-15 years, powerful new software tools have been introduced to help health plans identify critically ill members and better manage their care to improve outcomes and reduce costs. Such tools, however, can be challenging to implement. These plans need the insights and information the tools yield but don’t have the bandwidth or interest to implement new software, thus making outsourcing the best alternative.

Health information technology firms have become much more adept at simplifying the claims data specification process for payers. Health plans can now submit data in a secure, compliant manner and, in turn, receive the valuable, actionable insights they desire. Health plans can then integrate those insights into financing and managing better care for members, allowing proven health tech firms to do what they do best. Health plans are then better positioned to do what they do best. Now that’s a bargain Drucker would approve of.

I’ve learned a few things in the quarter century since the lamp incident. Now, I’m quite proficient at changing light bulbs and have even added a handful of home renovation skills to my repertoire. I do, however, know my limits. When necessary, I call in the experts and am happy to write a check. It’s the smart move, and I think my father-in-law would approve.

Clark Cameron is director of payer commercialization at 3M Health Information Systems.