High-Performance Health Plans
The Health Rosetta Framework
The Health Rosetta is a practical blueprint for employers who are done accepting double-digit premium increases. These eight principles separate high-performing plans from the rest.
What It Is
The Health Rosetta is a practical framework for building high-performance employer health plans. Developed by Dave Chase and codified through documented case studies, it identifies eight core principles that consistently separate high-performing plans from average ones.
Unlike theoretical models, the Health Rosetta is grounded in real employer outcomes — documented savings of 20–40% per employee while improving benefits. It is not a product or a vendor; it is a set of principles that guide plan design, vendor selection, and advisor relationships.
The framework recognizes that the U.S. healthcare system is not broken — it is working exactly as designed, rewarding volume over value. High-performing employers opt out of that system by building plans that pay for outcomes, not procedures.
Corry Hull is a certified Health Rosetta Advisor, trained in the framework and its application for mid-market employers. The Health Rosetta certification requires transparent compensation disclosure and a documented commitment to fiduciary-level advice.
The Eight Principles
How the Health Rosetta Works
Transparent Contracts
Every vendor contract — TPA, PBM, stop-loss, network — should be transparent, auditable, and aligned with the plan's interests. Hidden fees and opaque pricing are incompatible with high performance.
Direct Primary Care (DPC)
DPC practices charge a flat monthly membership fee for unlimited primary care access. Removing fee-for-service billing reduces unnecessary referrals, improves care coordination, and lowers total cost.
Advanced Primary Care
Beyond DPC, advanced primary care integrates behavioral health, care navigation, and chronic disease management into a single access point — reducing specialist utilization and ER visits.
Reference-Based Pricing
Instead of paying whatever a hospital bills, reference-based pricing sets reimbursement at a defined benchmark (e.g., 150–200% of Medicare). Members can use any provider; the plan pays the reference rate.
Smarter Pharmacy Benefits
Transparent PBM contracts, specialty drug management, biosimilar adoption, and site-of-care optimization are the levers. Pharmacy is the fastest-growing cost driver — and the most addressable.
Centers of Excellence
For high-cost, high-variation procedures (joint replacement, spine surgery, cardiac care), directing members to proven high-quality providers reduces complications, readmissions, and total cost.
Employee Advocacy
A dedicated advocacy service helps members navigate the healthcare system, resolve billing issues, and access the right care at the right cost. Advocacy reduces unnecessary utilization and improves member satisfaction.
Aligned Incentives
Every vendor in the plan ecosystem should be paid for outcomes, not volume. Fee-for-service arrangements create misaligned incentives that drive unnecessary utilization and cost.
Why It Matters
Why It Matters for Employers
"Employers who implement Health Rosetta principles have reduced per-employee health plan costs by 20–40% while improving benefits."
"The Health Rosetta framework is not theoretical — it is built on documented case studies from employers of all sizes across the country."
"Corry Hull is a certified Health Rosetta Advisor, trained in the framework and its application for mid-market employers."
Common Pitfalls
Common Mistakes to Avoid
- 1
Implementing one or two principles in isolation without a coherent overall strategy — limiting the compounding effect of the full framework.
- 2
Choosing a DPC provider without evaluating care model depth, behavioral health integration, and data sharing capabilities.
- 3
Implementing reference-based pricing without a robust member advocacy and balance bill resolution program.
- 4
Selecting a TPA or PBM that is not aligned with transparent, high-performance plan design.
- 5
Failing to communicate plan changes to employees in a way that builds trust and drives appropriate utilization.
FAQ
Frequently Asked Questions
Keep Learning
Related Resources
Resource Library
Employer Guides & Tools
Download checklists, calculators, and frameworks for high-performance plan design.
Browse resources →Blog
Health Reform Insights
Practical analysis of Health Rosetta principles, DPC, reference-based pricing, and more.
Read the blog →Related Pillar
PBM Consulting
Understand how transparent PBM contracts are a core Health Rosetta principle.
Learn about PBMs →Health Rosetta & Strategy Downloads
Ready to build a high-performance health plan?
Work with a certified Health Rosetta Advisor to implement these principles for your organization. Learn about the Health Rosetta Advisor program →