Pay Them Faster. Watch the Price Drop. A 48-Year Veteran Makes the Case for Rewiring Healthcare from the Inside.
Lawrence Thompson, founder and CEO of Benefit Systems Inc. and a nearly five-decade veteran of the payer, TPA, and self-insurance industries, joined the CLEARly Beneficial Podcast with a set of proposals that are specific, documented, and ready to implement. The system does not need more diagnosis. It needs someone willing to pull the trigger.
Sacramento, CA, June 11, 2026 --(PR.com)-- Lawrence Thompson has spent 48 years inside the machinery of American healthcare financing. He has founded and sold insurance companies and TPAs, run a company he built to 120,000 members, served as president of one of the largest independent TPAs in the country before selling it to UnitedHealth, lobbied Congress for more than 20 years on behalf of the self-insurance industry, and chaired the Self Insurance Institute of America. He knows where the money goes. And in this episode, he said exactly where it should go instead.
He sat down with host Vincent Catalano on the CLEARly Beneficial Podcast, released Tuesday, June 2, 2026. Listen now on Substack.
The Fastest Path to a 30 Percent Discount
Thompson’s central argument is not theoretical. He has tested it across 14 major physician practices in five states and six hospital systems. The question he asked each of them was simple: if we could pay you within 24 to 48 hours, how much would you discount your fees?
“They basically all told me 30 to 35 percent,” Thompson said. “Hospitals get paid on average in 93 days. I spoke to one hospital that has 101 people in a department that does nothing but fight appeals, go after billing, and try to collect money. It’s insane.”
His proposal: change the payment mechanism first. Pay providers faster by building a national PPO on the Medicare framework, eliminating pre-authorization, and passing the resulting savings directly to members rather than letting carriers pocket them. Once fees come down through faster payment, then cap them. The sequence matters. Capping inflated rates without first fixing the payment system, he argued, locks in the wrong baseline.
This episode covered:
Why paying physicians in 24 to 48 hours could produce 30 to 35 percent discounts on the cost of care
How a national PPO built on Medicare pricing could replace the current patchwork of carrier contracts
Why banning insurance carrier ownership of providers is a conflict of interest the industry has ignored for too long
The case for equal-nation drug pricing and banning direct-to-consumer pharmaceutical advertising
Why brokers should be paid flat fees, not commissions, and what that change would do to premium costs
How the Consolidated Appropriations Act is starting to force plan sponsor accountability
38 Years Later, the Same Paper Still Stands Up
The episode’s sharpest moment came when Thompson turned the conversation toward broker compensation. Thirty-eight years ago, he wrote a paper arguing that healthcare brokers should be paid the same way every other professional advisor is paid: a flat fee for a defined scope of work, not a percentage of what the client spends.
“Your CPA does not get paid as a percentage of how much tax you paid,” Thompson said. “He gets paid a flat fee. Your attorney gets paid a flat fee. If we really consider ourselves to be these magnificent, brilliant advisors that we all say we are, why aren’t we being paid like that?”
Catalano, who has analyzed 5500 compensation data for every employer in California, did not pull his punch either.
“I am so fed up with the brokerage community right now,” Catalano said. “The smart brokers, the ones who are up and comers, they should be going after that client who is paying the existing incumbent half a million dollars in commissions and come in with a flat fee arrangement.”
Thompson noted that commission-based broker compensation is not just a fairness issue. It is a math problem. Those commissions are built into stop-loss calculations and premium structures, adding meaningful dollars to what employers and employees pay every year.
About Lawrence Thompson
Lawrence Thompson is the founder and CEO of Benefit Systems Inc., a healthcare consulting and solutions firm he launched in 2002. With nearly five decades in the industry, his career spans payer, TPA, reinsurance, stop-loss, and consulting, including serving as president of Pomco Inc., one of the largest independent TPAs in the United States, which he sold to UnitedHealth in 2017; chief commercial officer of HealthNow New York, overseeing $2.8 billion in annual revenue; and chief strategy and revenue officer at Advanced Medical Pricing Solutions. He founded and grew his own TPA in California and Arizona to 120,000 members before selling it in 2001, and has been a licensed broker since 1978. Thompson is a past chairman of the Self Insurance Institute of America and spent more than 20 years lobbying on Capitol Hill for the self-insurance industry.
About Vincent Catalano and CLEAR Healthcare Solutions
Vincent Catalano is the founder and CEO of CLEAR Healthcare Solutions and host of the CLEARly Beneficial Podcast. With more than 23 years of experience in employee benefits and healthcare consulting, including senior roles at Arthur J. Gallagher, Catalano founded CLEAR Healthcare Solutions to provide independent, unbiased healthcare benefits consulting. His position outside corporate constraints allows him to speak candidly about industry issues that others cannot. New episodes of the CLEARly Beneficial Podcast release weekly. Learn more at clearhcs.com.
Listen Now
Subscribe on Substack for full episodes, show notes, and bonus content:
Substack: clearlybeneficialpodcast.substack.com/p/s2e19-healthcare-big-ideas
YouTube: https://youtu.be/YvWeZWQWV7c
He sat down with host Vincent Catalano on the CLEARly Beneficial Podcast, released Tuesday, June 2, 2026. Listen now on Substack.
The Fastest Path to a 30 Percent Discount
Thompson’s central argument is not theoretical. He has tested it across 14 major physician practices in five states and six hospital systems. The question he asked each of them was simple: if we could pay you within 24 to 48 hours, how much would you discount your fees?
“They basically all told me 30 to 35 percent,” Thompson said. “Hospitals get paid on average in 93 days. I spoke to one hospital that has 101 people in a department that does nothing but fight appeals, go after billing, and try to collect money. It’s insane.”
His proposal: change the payment mechanism first. Pay providers faster by building a national PPO on the Medicare framework, eliminating pre-authorization, and passing the resulting savings directly to members rather than letting carriers pocket them. Once fees come down through faster payment, then cap them. The sequence matters. Capping inflated rates without first fixing the payment system, he argued, locks in the wrong baseline.
This episode covered:
Why paying physicians in 24 to 48 hours could produce 30 to 35 percent discounts on the cost of care
How a national PPO built on Medicare pricing could replace the current patchwork of carrier contracts
Why banning insurance carrier ownership of providers is a conflict of interest the industry has ignored for too long
The case for equal-nation drug pricing and banning direct-to-consumer pharmaceutical advertising
Why brokers should be paid flat fees, not commissions, and what that change would do to premium costs
How the Consolidated Appropriations Act is starting to force plan sponsor accountability
38 Years Later, the Same Paper Still Stands Up
The episode’s sharpest moment came when Thompson turned the conversation toward broker compensation. Thirty-eight years ago, he wrote a paper arguing that healthcare brokers should be paid the same way every other professional advisor is paid: a flat fee for a defined scope of work, not a percentage of what the client spends.
“Your CPA does not get paid as a percentage of how much tax you paid,” Thompson said. “He gets paid a flat fee. Your attorney gets paid a flat fee. If we really consider ourselves to be these magnificent, brilliant advisors that we all say we are, why aren’t we being paid like that?”
Catalano, who has analyzed 5500 compensation data for every employer in California, did not pull his punch either.
“I am so fed up with the brokerage community right now,” Catalano said. “The smart brokers, the ones who are up and comers, they should be going after that client who is paying the existing incumbent half a million dollars in commissions and come in with a flat fee arrangement.”
Thompson noted that commission-based broker compensation is not just a fairness issue. It is a math problem. Those commissions are built into stop-loss calculations and premium structures, adding meaningful dollars to what employers and employees pay every year.
About Lawrence Thompson
Lawrence Thompson is the founder and CEO of Benefit Systems Inc., a healthcare consulting and solutions firm he launched in 2002. With nearly five decades in the industry, his career spans payer, TPA, reinsurance, stop-loss, and consulting, including serving as president of Pomco Inc., one of the largest independent TPAs in the United States, which he sold to UnitedHealth in 2017; chief commercial officer of HealthNow New York, overseeing $2.8 billion in annual revenue; and chief strategy and revenue officer at Advanced Medical Pricing Solutions. He founded and grew his own TPA in California and Arizona to 120,000 members before selling it in 2001, and has been a licensed broker since 1978. Thompson is a past chairman of the Self Insurance Institute of America and spent more than 20 years lobbying on Capitol Hill for the self-insurance industry.
About Vincent Catalano and CLEAR Healthcare Solutions
Vincent Catalano is the founder and CEO of CLEAR Healthcare Solutions and host of the CLEARly Beneficial Podcast. With more than 23 years of experience in employee benefits and healthcare consulting, including senior roles at Arthur J. Gallagher, Catalano founded CLEAR Healthcare Solutions to provide independent, unbiased healthcare benefits consulting. His position outside corporate constraints allows him to speak candidly about industry issues that others cannot. New episodes of the CLEARly Beneficial Podcast release weekly. Learn more at clearhcs.com.
Listen Now
Subscribe on Substack for full episodes, show notes, and bonus content:
Substack: clearlybeneficialpodcast.substack.com/p/s2e19-healthcare-big-ideas
YouTube: https://youtu.be/YvWeZWQWV7c
Contact
CLEAR Healthcare Solutions
Vincent Catalano
(916) 284-6973
www.clearhcs.com
Vincent Catalano
(916) 284-6973
www.clearhcs.com
Contact
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