The High Performance Health Plan Framework™

10 Components. 100 Points. One Objective.

Better healthcare at a sustainable cost.

This is the canonical definition of The High Performance Health Plan Framework™. Its 10 components give employers a practical operating system for moving from passively purchasing health insurance to actively managing the economics, care and experience underneath the plan. Employer Benefits IQ applies these same components through decision-support tools and resources.

An executive view of health plan performance

Three layers. One management system.

The Framework organizes ten interconnected decisions into a clear sequence: control the economics, improve the healthcare and make the work sustainable.

Foundation

Control the economics

Build visibility, financing discipline and risk protection before pursuing isolated cost-containment ideas.

Plan Financing & Risk Strategy

Are we financing healthcare in the most efficient way for our organization?

Explore component

Data, Analytics & Transparency

Do we actually know where our healthcare dollars are going?

Explore component

Medical Network & Provider Economics

Are we paying reasonable prices for high-quality healthcare?

Explore component

Pharmacy & Specialty Drug Management

Do we understand the economics behind every pharmacy dollar?

Explore component

Stop-Loss & Catastrophic Risk

Are we protecting the plan against catastrophic claims without unnecessarily transferring dollars to an insurer?

Explore component

Strategy

Improve the healthcare

Design better access and better pathways for the care moments that shape both cost and employee experience.

Primary Care & Early Intervention

Can employees access high-quality care before small problems become expensive ones?

Explore component

High-Cost Care & Clinical Strategy

Do employees have a better pathway when healthcare becomes expensive or complex?

Explore component

Navigation & Employee Experience

Can employees actually figure out how to use the health plan?

Explore component

Governance

Make it sustainable

Create the accountability, communication and measurement practices that make progress durable.

Fiduciary Governance, Contracts & Accountability

Can the employer demonstrate that the plan is being managed prudently and in the interests of participants?

Explore component

Employee Engagement, Communication & Measurement

Are employees using the plan the way it was designed—and can we prove the strategy is working?

Explore component

Composite employer illustration

Use examples to understand the management work—not to predict a result.

This illustration combines outcome patterns from multiple engagements to show the connection between deliberate methodology, disciplined implementation and business decisions. It is not a documented client case study.

Composite Employer Illustration — Manufacturing

Illustrates the potential management shift from passive renewal to a more transparent financing strategy.

$1.4M

first-year savings

22%

PEPM reduction

stop-loss carriers evaluated

This composite illustration combines themes and outcome patterns from multiple engagements. The figures are illustrative, not a single documented client result or a promise of results. Individual outcomes depend on plan design, baseline conditions and implementation decisions.

The goal is performance, not simply a lower price.

The plan is not a product to renew.

It is a business system to manage. The Framework focuses attention on the choices, contracts and evidence behind the renewal result.

No single solution is right for every employer.

Funding models, networks and vendors should follow the employer’s objectives, population and capacity—not the other way around.

The goal is performance, not simply a lower price.

The most durable strategy balances cost, quality, access, risk, employee experience and sustainability.

See how the Score works

Put the methodology to work

Apply the HPHP methodology with .

Employer Benefits IQ is the practical application platform for employers who want to use education, tools, data, vendor intelligence and decision support in real-world benefits decisions.

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tools and decision support

Apply the Framework

Want help applying the Framework to your organization?

Schedule a High Performance Health Plan Strategy Session with Corry Hull.

Request a Strategy Session