When Liz Hill joined Advance Auto Parts as director of benefits two and a half years ago, she faced a challenge many HR leaders are familiar with: healthcare costs were increasing faster than wages, and employees were questioning the value of their medical plans. For a workforce of 60,000, around 70% male, with an average age of 46, and spread across 4,300 locations, the situation was especially dire. 

“I’ll never forget the first conversation I had with a frontline manager,” Hill said during a From Day One webinar. “I asked what he wanted me to know about the medical plan. He said, ‘Oh, the medical plan, that’s for our older, more mature workforce.’” Hill saw that perception as a red flag. Younger employees were opting out entirely, viewing the high deductibles as too risky when they felt healthy. 

In 2025, Advance Auto Parts faced healthcare trend increases of 13%, which was well above the industry average of 9%. Hill knew she needed a new approach, and one that wouldn’t shift costs to employees or disrupt their existing coverage. 

The Provider Quality Problem 

The solution came from an overlooked option: helping employees choose better doctors. Research shows that the single biggest factor in a patient’s health outcomes and total cost of care is the individual provider they see. Yet most employees choose doctors by word of mouth or checking online reviews, and neither method necessarily correlates with cost efficiency or high-quality care. 

Lauren Chucko, senior vice president of account management at Garner Health, illustrated this with a striking example. Two spine surgeons, who were both quite popular among employees, had dramatically different outcomes. The first had patients who frequently experienced complications and needed revision surgeries. The second surgeon used minimally invasive techniques, had lower complication rates, and his patients spent significantly less—$69,000 in total claims versus $172,000, with zero out-of-pocket costs for members. 

Traditional provider evaluation methods, which merely average the previous year’s costs, had ranked the first doctor higher. But Garner’s database of 300 million patients, applying 550 different clinical metrics, revealed that the second doctor was actually superior across multiple measures: fewer unnecessary surgeries, lower complication rates, and more appropriate use of outpatient procedures.

A Multi-Pronged Strategy 

Hill approached this challenge systematically, using what she called a “multi-pronged strategy.” This included operational improvements like carving out subrogation, pharmacy changes, and tightening leave of absence processes. But the largest opportunity was in value-based care. 

Rather than switching to a narrow network or committing to a specific carrier, Hill chose Garner’s plan-agnostic approach. The company maintained its full Anthem Blue Cross network but added a powerful incentive: employees who used Garner’s top-rated providers would have their out-of-pocket costs reimbursed up to $2,000 for individuals and $4,000 for families. 

“For a highly price-sensitive population like mine, that’s substantial,” Hill said. The plan was intentionally placed on Advance Auto Parts’ middle-tier option, which increased the deductible from $1,500 to $2,500 but offered the Garner reimbursement. The message was clear: use better doctors, save money. These innovative, outside-the-box solutions are exactly what’s needed to reduce spending while cutting costs in healthcare, without compromising the quality of care. 

The Importance of Communication

Hill’s team knew the success of these policy adjustments hinged on communication. They didn’t just announce the change; they orchestrated what one colleague called a “communication wheel” that kept turning through multiple phases. 

Before open enrollment, they trained the entire HR team, not just benefits specialists. During enrollment, they made creating a Garner account part of the required enrollment process in their benefits administration system. This was a crucial step that Hill credits with high adoption. They mailed customized materials to all 4,300 store locations, and ran content on TVs in stores and distribution centers. 

They also made a crucial naming decision: the plan became the “Anthem Silver Plus Garner Money Plan.” As Hill noted, “When you ask employees what medical plan they’re in, they often don’t know. So let’s call the plan what it is.” 

The approach worked. Despite having a passive enrollment system where employees could simply stay in their existing plan, 44% of the workforce enrolled in the Garner plan. More impressively, 53% of those enrolled created Garner accounts, well above the 30% benchmark. 

Hill’s advice for other benefits leaders is straightforward: dig into the data to build confidence in the methodology, communicate relentlessly through every available channel, and don’t be afraid to push vendors to customize solutions for your unique workforce. Most importantly, she emphasized, “When you make this decision, you’ve got to be all in from a communications perspective.” 

Editor's note: From Day One thanks our partner, Garner Health, for sponsoring this webinar. 

Grace Turney is a St. Louis-based writer, artist, and former librarian. See more of her work at graceturney17.wixsite.com/mysite.

(Photo by MonthiraYodtiwong/iStock)