Jude Odu is the founder of Health Cost IQ, a healthcare analytics company and is the author of Model Optimal Care: End US Healthcare Waste, One Health Plan at a Time.
A healthcare technology veteran with more than 25 years of experience, he has worked across all major sectors of the U.S. health system, from commercial payers to hospital systems to enterprise software and academia. His doctoral-level research into employer-sponsored health plans revealed systemic waste far exceeding what had been previously published.
He holds a B.S. from Ursuline College (Summa cum Laude), an M.S. from The George Washington University (cum Laude), and has completed doctoral coursework at Cleveland State University.
For years I have written some version of the same paragraph on this blog. Your plan is bleeding money. The law already gives you the authority to find it. Then the post ends and the work is still yours. That changed on September 8. MOC Fiduciary Intelligence is live.
Every self-funding conversation starts with the same question. Are we big enough? It is the wrong one, and it has been for a while. Sixty-seven percent of covered U.S. workers are already in self-funded plans. Two things actually decide whether a transition works, and neither one is your headcount.
On December 23, 2025, Schlichter Bogard sued four large employers and named their benefits consultants alongside them. Plaintiffs allege brokers took 22 to 40% of premiums on voluntary benefits while comparable plans paid about 10%. The breach was not what the broker did. It was what the employer never asked. Here is what to request before renewal.
For the fourth year running, cancer is the top condition driving cost in employer health plans. Eighty-eight percent of large employers now rank it among their top three.
Raising a deductible does not change what your plan pays for an oncology episode. It changes who writes the first check.
Here are four moves to make before your next renewal: find where the dollars actually go, benchmark drug prices against public data, build a Center of Excellence path, and treat cancer screening as a cost strategy.
On July 1, Congress held a hearing on direct contracting. Five days earlier, a New York union skipped its insurer, went straight to a hospital system, and put itself on track to save $46 million. You can do the same with both care and pharmacy. Here is how direct sourcing works, and why it is the fiduciary oversight your plan already owes its members.
CMS just reported the U.S. spent $5.7 trillion on health care in 2025, up 7.3% over 2024.
My book Model Optimal Care projected $5.6 trillion, so the waste math holds, and the top of the $760 billion to $1.6 trillion range now sits even higher.
This problem isn’t going away soon. Here is what self-funded employers should do now.
Your TPA controls your claims data, and renewal is the only point each year when you can change that. With 67% of covered U.S. workers in self-funded plans, your data is a plan asset you must monitor. This post shows what your contract may be hiding, what the law now requires, and concrete steps to take before you sign off on that next renewal.
On January 1, Medicare’s negotiated prices took effect for ten of the most expensive drugs in the country. Januvia dropped from $527 to $113 a month. Eliquis fell to $231. For the first time, you have a federal price tag for the medications your plan pays for every month. Here is how to use those public numbers to test whether your PBM charges you a fair price.
Mercer says employer health costs will top $18,500 per worker in 2026, and 51% of large employers are responding the same way: raise the deductible. That move does not cut cost. It shifts it onto your employees and leaves the waste untouched. With 25% to 30% of healthcare spending wasted, the real savings sit in your own claims data. Here are five actions that cut real cost this year.
Stop-loss renewals are climbing in 2026 as million-dollar claims rise 29%. Five steps self-funded plans can take now to control cost and meet ERISA duty.
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