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The Return of American Manufacturing Demands a Chief Health & Benefits Officer (CHBO) to Fix Benefits Procurement

By MATT McCORD

American manufacturing is making a comeback. Driven by tariffs, supply chain instability, and shifting economic priorities, companies are reshoring production—reinvesting in U.S. labor and operations.

But there’s one major obstacle still standing in the way: the crushing cost of American healthcare.

For decades, U.S. employers have overpaid for healthcare without improving outcomes. Ballooning insurance premiums bloated administrative costs, and an opaque, middleman-driven system have left businesses with the highest healthcare costs in the world—twice as much as top global competitors.

If manufacturing is returning, shouldn’t we be demanding a more efficient and productive healthcare model to support it? The same industries that once offshored to escape labor costs must now confront the reality that the old way of buying healthcare is broken.

The Consolidated Appropriations Act (CAA) & The Growing Fiduciary Risk

The game has changed. The Consolidated Appropriations Act (CAA) of 2021 imposes strict new fiduciary requirements on employers that sponsor health plans. Companies can no longer blindly trust big insurance carriers or PBMs to act in their best interest.

If businesses fail to properly manage their healthcare spend, they are now liable for excessive costs, lack of transparency, and conflicts of interest.

🔴 This isn’t just theoretical—JP Morgan Chase is now facing a class-action lawsuit over how it managed its employee health plan, with board members named as defendants.

Employers have always scrutinized office supply costs, travel budgets, and vendor contracts—yet they’ve handed over healthcare procurement to third-party insurers with zero accountability.

Now, that lack of oversight is a legal risk.

Why Employers Need a Chief Health & Benefits Officer (CHBO)

Every major business function has an executive leader ensuring strategy, efficiency, and accountability:

  • CFOs manage financial health with precision.
  • COOs streamline operations for maximum productivity.
  • CIOs leverage technology to drive innovation.

So why do we continue to let third-party insurers and middlemen dictate healthcare purchasing without a dedicated executive overseeing the strategy?

Mark Cuban recently called for a new C-suite role: the Healthcare CEO (HCEO). A more appropriate and less confusing term may be the Chief Health & Benefits Officer (CHBO).  This leader would act as a fiduciary to the company, ensuring that its health benefits strategy delivers better outcomes at lower costs—just like a CFO does with financial oversight.

This isn’t a job for HR.

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How Did My 2011 Predictions Turn Out?

Pretty well, actually.

As predicted last December, there was no big change to health care reform, doctors still didn’t have enough time with their patients, Microsoft (disclosure: Microsoft is a Best Doctors client) made moves to create a “Windows” for electronic health records, and “ACO” became the hot buzzword in health care.  Some state governments started major redesigns of their benefits programs, saving money in the same ways private sector employers do.  Meanwhile, more than ever, private sector employers are penalizing employees who don’t take care of themselves.

Misdiagnosis finally started to be recognized as a public health problem.  At Best Doctors we got a great deal of press coverage in 2011 on this (for a few examples, go herehereherehere and here).  I will sneak in a 2012 prediction and tell you that you will hear a lot more about this this year, and not just from us.

What did I get wrong?

Well, I said no major employer would drop their health benefits – and none did, so I didn’t really get this wrong.  But I was surprised to hear some very major employers quietly talking about their plans for dropping coverage in 2014.  It’s a bad idea – and I would have thought its badness would have been enough to keep it off the table.  For some employers, apparently not.

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