At the 10-year anniversary of the NextGen Mastermind Conference, the agenda didn’t promise spectacle. No laser shows. No headline bands. Just a quiet, deliberate gathering of people rethinking an industry that resists being rethought. And in the middle of it – an award handed out not for style, but for substance.

John Clay, President of Better Source Benefits, walked away with the coveted “Mr. RBP” title – a distinction less about applause and more about audacity. Awarded by industry veteran Nelson Griswold, the mastermind behind the NextGen Partnership.

– Let’s start with the obvious question: Why RBP? Why now?

“When we were kids,” Clay said, “insurance had standards—‘usual, customary and reasonable.’ We’ve traded that in for a discount off imaginary numbers. Providers inflate prices off a fictional charge master, and insurers pretend they’re offering a deal. It’s like getting 60% off a Rolex that was priced at a million dollars. Congratulations. You’ve been robbed politely.”

Enter reference-based pricing (RBP). Instead of paying based on made-up charges, RBP sets costs as a multiple of Medicare – an actual, transparent benchmark grounded in reality, not fiction. “It’s not a loophole,” Clay adds, “It’s a return to logic.”

So… Why Aren’t Employers Running to RBP Like It’s Black Friday?

Clay doesn’t hesitate: “Because the real buyers – CEOs and CFOs – don’t see the solutions. HR does. And HR loves the status quo.”

It’s the quiet corporate tragedy no one talks about. Decisions that impact millions of dollars are routinely handed to departments with zero profit-and-loss responsibility. “It’s like letting someone who’s never driven design your car,” Clay jokes. “And then being surprised when it doesn’t turn.”

And the fear? Not the plan. Not the cost. It’s the noise.

“Nobody gets fired for picking Blue Cross,” Clay explains. “But God help you if Karen from Accounting can’t figure out her lab benefits. She’ll burn the office down and take you with it.”

Why Most Healthcare Plans Are Built for Optics, Not Outcomes

Here’s the truth: Most employers aren’t building plans for outcomes. They’re building plans that look good in a boardroom slide deck. And that means big logos, brand names, and avoiding anything that sounds remotely unfamiliar – even if that unfamiliar thing is the only tool that can actually rein in costs.

“Large hospitals look better on paper,” Clay says, “but lower-cost providers often have better outcomes. They do it more often, with fewer complications. It’s not sexy – but it works.”

What’s stopping employers from embracing this? Short-term thinking. The average employee tenure is seven years. The average broker pitch lasts seven minutes. And most healthcare decisions are made 30 days before renewal, in panic mode, over a stale bagel and a spreadsheet.

“That’s why we start six months out,” Clay emphasizes. “We negotiate early, educate throughout, and make sure every person – especially the Karens – knows what to expect. Education kills noise.”

Managing Karen: The Art of Controlling Chaos

And what about the dreaded noise – the employee who causes so much drama you’d think they were denied oxygen, not an out-of-network copay?

“We don’t pretend people won’t panic,” Clay admits. “We prepare the client for it. Like a property & casualty broker walking through every scenario – here’s what can go wrong, here’s what we’ll do when it does. You defuse the bomb before it explodes.”

Because in this business, noise isn’t a side effect. It’s the product. “Everyone’s paid a salary to avoid conflict. So when conflict shows up, they punt it. If you’re the broker who takes ownership instead of punting, you’re not just different – you’re indispensable.”

Final Word

John Clay didn’t win “Mr. RBP” because he makes the loudest argument. He won because he makes the clearest one. In a world of opaque pricing, passive brokers, and decision-making by plausible deniability, Clay’s approach is simple: take control, educate early, and confront the noise before it starts.

Or as he puts it:

“Most employers are managing optics. We’re managing outcomes.”

And in an industry that thrives on confusion, clarity might just be the most disruptive benefit of all.

Escape the system, or just continue feeding it… Your gateway is here >>