EP450: When Your Health Plan Is $9 Million in the Hole, Who Are You Going to Call? A CPA. And Tell Them to Bring Their Spreadsheets, With Marilyn Bartlett, CPA, CGMA, CMA, CFM

In Episode 450, Stacey Richter speaks with Marilyn Bartlett, a renowned CPA in the healthcare field, about her remarkable achievement of transforming the state of Montana's employee health plan from $9 million in debt to a surplus of $112 million within three years. Marilyn discusses the steps she took, including identifying financial inefficiencies, targeting high-cost areas, and implementing data-driven strategies to produce quick wins and sustainable results. The conversation delves into the importance of having the right team, communicating effectively with stakeholders, and staying focused amidst challenges. Listeners will gain valuable insights into strategic change management and actionable advice for improving healthcare plans.

WHAT YOU'LL LEARN

✅ How Marilyn Bartlett transformed Montana's state employee health plan from $9 million in debt to a $112 million surplus in three years

✅ What gave Marilyn the confidence — and the mandate — to make sweeping changes to a state health plan

✅ What "quick wins" looked like early in her tenure, and why they mattered for building momentum

✅ How Marilyn structured her plan and built the right team to execute it

✅ What happened to plan costs after Marilyn moved on, and what that says about the durability of the changes she made

WHY THIS MATTERS

It's amazing what a dedicated CPA with a spreadsheet and their eye on the target can accomplish in the real world when they just follow the dollar. Marilyn Bartlett isn't called the "Queen of Healthcare" for nothing — she was among the first to systematically identify how much money was getting pulled out of the pockets of taxpayers, employers, and plan members and into the healthcare, insurance, and consulting industries, and then actually do something about it.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction.

06:45 What gave Marilyn the confidence to fix Montana's state health plan?

08:11 Why Marilyn knew she would have enough power to make the changes needed in Montana's state health plan.

09:11 What Marilyn achieved in her time as the administrator of the Montana State Employee Health Plan.

10:38 What were the "quick wins" Marilyn was able to achieve when she first took over as administrator?

17:33 Stay tuned for an upcoming episode that covers RFP in detail.

17:50 How Marilyn structured her plan for the Montana State Employee Health Plan.

21:21 What's the key to setting yourself up for success when doing what Marilyn was able to achieve?

25:02 Why putting together your own team is so important.

29:07 What happened when Marilyn left the Montana State Employee Health Plan?

31:08 Have the costs of the plan gone up since Marilyn's time working on it?