The Benefits P&L Problem
Nobody Owns
Most employers don't have a healthcare cost problem—they have an accountability problem. Costs rise, vendors shrug, brokers call it "trend," and finance gets a number with no evidence.
The Real Problem
Benefits spend is treated like weather: it happens, it's expensive, and everyone shrugs. That mindset is how you end up with "trend" as an explanation instead of an actual model.
The fix is boring and powerful: treat benefits like a controllable financial system.
What "Controllable System" Means
- Demand claim-level reconciliation: Tie invoices to claim lines so you can verify vendor math
- Require contract definitions that don't move: What counts as "specialty"? What's the MAC list source? Lock it down.
- Benchmark NDC-level pharmacy economics: Compare what you paid vs what you should have paid, drug by drug
- Put GLP-1 on measurable control architecture: Eligibility rules, re-auth checkpoints, escalation monitoring—not panic or denial
The Accountability Gap
If your team can't explain why cost changed from last month to this month—at the category and driver level—you don't have a strategy. You have a monthly surprise.
And surprises compound. When finance can't trust the benefits P&L, they treat it like an uncontrollable line item. That creates budget pressure, vendor dependency, and strategic drift.
What to Do Next
Stop accepting vendor summaries as if they're audited financials. Demand evidence trails. Build the reconciliation muscle internally or bring in partners who do this for a living.
Kincaid IQ exists to turn that surprise into a model—so leadership can make decisions based on evidence, not vendor narratives.
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