Dr. Yele Aluko

Unlocking the Untapped Leverage of ESI

The U.S. health system delivers exactly what it was built to produce: fragmented access, opaque pricing, and misaligned incentives. One of the most powerful levers for change, Employer-Sponsored Insurance (ESI) represents over $1 trillion in annual spend, but is still managed as a cost center rather than a strategic asset. Drawing on his experience, Dr. Yele Aluko shows how large employers can shift from passive purchasers to active architects of value—redesigning payer relationships, enforcing accountability, and aligning incentives around measurable health outcomes.

Key Takeaways: Employers must use their leverage to reposition ESI from HR function to enterprise strategy. Payer transformation requires outcomes-based contracting. Employers can align incentives across payers and providers by linking spend to measurable health and workforce outcomes. Data transparency and governance are essential.