By Scott Wooldridge // Photography by Kevin Garrett
Josh Butler is an early riser. The founder of Butler Benefits has a hectic life running his company and raising two boys with his wife Allison, so he’s up at 5 am. The early personal time has become valuable to him.
“I don’t get a lot of alone time,” he says. “I don’t stay up very much longer than my kids do, so I find that if I want that personal time, I’m going to have to get it early in the morning.” Butler uses the early hours to meditate, pray, do light exercise, and spend a little time reading about his other interests: hunting, fishing and cooking.
“It’s just about doing something for yourself,” he adds. “Just some other hobbies, where you’re not focused 100 percent on work all the time.”
Soon enough, that work comes back into focus. Butler drops his oldest son off at school, just across the highway from his office. Then his day is all business. “My primary focus is on sales,” he says. “I’m heavily involved in renewals as well as new accounts. I usually get out of there around 6 to 6:30 every evening.”
A family tradition
Butler’s company is based in Amarillo, Texas, an area similar to where he grew up in northern Texas. He feels right at home. “Hands down, the people here in the Texas Panhandle are what makes this town special and unique,” he says. “It’s the largest small town I’ve ever lived in, and I’ve lived in a few small towns. People are friendly, and they’re hard-working. West Texas is rugged, and we rely heavily on our individualism.”
Butler also puts a strong emphasis on family. He mentions hunting and fishing trips and family vacations. Being a business owner has also been a long tradition in both his family and his wife’s.
“Both my wife’s family and my family are all entrepreneurs and own their own companies,” Butler says. “I grew up working our family farm and ranch, as well as in the oil and gas business. My grandfather was the patriarch of the family business, and it was his vision everyone followed. I admired that, watching my grandfather, my father, my uncles, and also my mother work towards achieving goals and fulfilling his vision. I have the same admiration for both sides of my wife’s family, and how they’ve successfully built their companies to what they are today.”
Butler’s earliest ambition was to own a hunting ranch in rural Texas, but life took him in another direction after college—first as a manager in an entertainment chain and then into insurance. Now his firm is pioneering cutting-edge reforms in the brokerage community, championing ideas such as direct-contracting and full disclosure of compensation by health insurance brokers and consultants.
So, although Butler’s background is traditional and conservative, his approach to business leans heavily on innovation and the reform of longstanding practices.
A changing industry
Butler founded his brokerage with Allison eight years ago. At first, their approach to the industry was pretty conventional. Then they discovered Health Rosetta, an industry-based health benefits reform movement, and Q4i, a brokerage consulting firm.
The messages of these groups appealed to Butler. “I watched Dave Chase’s Ted Talk about how health care has stolen the American Dream and it really resonated with me,” he says. “I had witnessed firsthand what he was describing, things like people forgoing medical treatment because they couldn’t afford to pay their deductible, and businesses having to cut other critical areas in their businesses just to pay for health insurance.
“I saw how this was impacting individuals and businesses, and to discover that something could be done differently to stop this really resonated,” Butler adds. “The ideals of transparency and fairness also resonated with me."
“At my core, I just want things to be fair for people, and the status quo in health care is anything but fair and transparent.”
These industry groups promote innovations such as direct-purchasing, where health care purchasers’ contract directly with providers to reduce costs. Using the reform ideas, Butler has been helping employers directly contract with providers and lower costs. The savings can then be reallocated to other benefit offerings.
“What we started to realize is, if I represent the payer—which is the self-funded employers—then what if we just establish more direct relationships between hospitals and surgery centers and surgeons and radiology centers,” he says. By talking to providers and helping them understand how they can save money under the system, a new set of commonalities can be created.
“It’s been phenomenal to watch this spread and metastasize,” Butler says. “Because most providers also realize that the status quo in health care is just unsustainable—it’s getting to the place where nobody can afford it.”
Butler recalls a conversation with a hospital CEO, where he discovered hospitals in Texas nearly always have to write off big parts of the deductible payments of patients. The problem, Butler says, is that deductible costs are simply too high for patients to pay them. “Most people are not paying these bills out of necessity. They simply can’t afford it.”
Butler realized that if he could help hospitals solve that problem and reduce uncompensated care costs, they were much more likely to work with him to lower the price tag of services for clients. “Most of them love this concept,” he says. “Not every hospitable is agreeable to these types of deal, but especially here in west Texas these rural hospitals are extremely open to the notion.”
The pandemic hits home
The pandemic hit home in a much more personal way just months ago, in December 2021, when Butler became seriously ill with COVID.
“I had very severe COVID pneumonia,” he says, adding that he avoided hospitalization in part because his direct primary care physician had a plan and could oversee his care. His wife and family members provided care for him at home. “If I hadn’t had those players in place or that model in place for my primary care needs, I would’ve been in an ICU on a ventilator,” he says.
Butler also sees the growing awareness around the importance of mental health as an outcome of the pandemic.
“We’re starting to see the manifestations of what isolation can do to people,” he says. “When people are more isolated, then we see a spike in the claims for depression and anxiety.
“I didn’t really fully understand this before I got sick myself,” he adds. “The reality is, we need interaction with people. We just do, especially when you’re suffering and sick you think you might die. Those are the moments in a human being’s life when they need people more than ever.”