In this episode, Spark Health Advisors CEO, Lindsey Kratzer, sat down with Steve Ditto—healthcare executive, patient advocate, and author of the Health Plan Compliance Advantage—to unpack what fiduciary duty actually requires from employers, and what that means for the vendors, brokers, and advisors trying to serve them.

Key Insights from Our Conversation:
1. Fiduciary pressure is rising fast. Employers are legally obligated to act solely in the best interest of their employees—not the plan, not their company, and certainly not their vendor relationships.

2. Legal precedent is shifting. Class action lawsuits against J&J, Wells Fargo, and JPMorgan are spotlighting failures to use disciplined, transparent decision-making—especially around pharmacy benefit contracts. Expect more scrutiny going forward.

3. Opaque vendor models create exposure. Most PBM contracts are filled with hidden fees, rebate games, and pricing tactics that employers can’t easily audit. Vendors who rely on complexity instead of clarity are becoming a liability.

4. Point solution fatigue is real—but so is the appetite for innovation. Employers want fewer vendors, not less innovation. They’re seeking solutions that simplify—not fragment—their benefit strategy, while still improving outcomes and cost control.

5. Bundling with carriers introduces risk. Buying everything from a single insurance partner may feel efficient, but it often introduces fiduciary conflicts that are harder to defend. 

6. Compliance-savvy vendors will win. The most successful companies in this space will be the ones that make it easy for employers to justify the decision—clear pricing, measurable outcomes, documented value, and support for a rigorous procurement process.