Fixing Healthcare by Donovan Pyle | Book Overview

The Wake-Up Call: Why U.S. employers waste an estimated $4,000 per employee per year on healthcare — totaling more than $300 billion annually — and why the traditional system is designed to keep it that way. How We Got Here: The history of employer-sponsored healthcare from World War II wage controls through the consolidation of the insurance-broker-PBM complex. Brokers and the Great Misalignment: How broker compensation structures (commissions, retention bonuses, PBM kickbacks, and Market Derived Income) create direct conflicts with employer interests. The Solution — Fiduciary Thinking: What fiduciary duty means under ERISA, how fee-based compensation eliminates conflicts, and why the CPA analogy makes the choice obvious. 

Success Tools and Frameworks: The APIM Framework (Assess, Procure, Implement, Manage), the Total Benefits Assessment, and the Health Plan Maturity Model — practical tools for measuring and improving your benefits program. Building Your Benefits Dream Team: Selection criteria for in-house experts and fiduciary-based consulting firms, including a scoring methodology for evaluating potential partners. Switching to a Fiduciary-Based Firm: A practical guide to timing, transition planning, avoiding disruption, overcoming legacy broker resistance, and the onboarding process.

Donovan Pyle is the CEO and Founder of Health Compass Consulting, a fiduciary benefits management consulting firm. He holds both the CHVP (Certified Health Value Professional) and REBC (Registered Employee Benefits Consultant) designations and was named the 2025 Benefits Advisor of the Year by the Validation Institute. Donovan chairs the CHVP Advisory Board and is a contributor to BenefitsPRO and the CFMA’s Building Profits magazine. Beyond his domestic practice, Donovan is a recognized international authority on healthcare commercial architecture and fiduciary reform. 

Featured as an expert in Bloomberg Law on employer liability and broker transparency, he advises governments, ministries of health, and multinational employers on designing regulatory frameworks that prevent legacy brokerage incentive models from inflating costs in international markets. He is the creator of the Global Commercial Market Architecture™ framework — helping international markets build commercial firewalls against the same intermediary-driven inefficiencies that plague the U.S. system. His mission is to help employers worldwide stop overspending on healthcare by eliminating broker conflicts of interest and installing governance systems that drive measurable results.