Learnings
Taking a Chance on a Something New: Breaking Away from Legacy TPAs Can Be Worth the Risk
There is a certain comfort in the familiar.
For years, employers, brokers, and organizations have partnered with the same third-party administrators (TPAs), relying on established names, familiar processes, and systems that, in many cases, have been around for decades. There is value in stability, particularly when you’re dealing with something as important and complex as benefits administration.
But there is also a question worth asking: Is familiar always better?
I ask that question from experience, not observation alone.
I’ve spent many years working within the traditional TPA environment. I’ve seen the value of established organizations, the importance of operational experience, and the complexity involved in administering benefits and processing claims. I’ve also experienced the challenges that can come with legacy processes, established infrastructure, and the difficulty of changing the way things have always been done.
Eventually, I decided to step outside that familiar environment and take a chance on something different. I joined Yuzu as team member number seven to help build the foundation of changes needed to make a difference. I joined a team of incredibly talented individuals who share a common belief: healthcare administration can be better, and we’re willing to challenge the way things have traditionally been done to help make that happen.
Having experienced both environments, I believe there is an opportunity to bring industry knowledge and experience together with a willingness to rethink what has become standard. Because just because something has always been done a certain way doesn’t mean it’s the best way. And just because a company has been around for decades doesn’t automatically mean it’s delivering the best service, technology, or experience.
The Cost of “We’ve Always Done It This Way”
Legacy TPAs didn’t become successful by accident. Many have built impressive organizations, served thousands of clients, and developed sophisticated processes designed to manage complexity at scale.
The challenge is that scale can sometimes bring bureaucracy.
A simple question may require multiple handoffs. A technology improvement may take months, or even years, to implement. A customer request may have to fit within a rigid process designed long before today’s expectations existed. Over time, these frustrations can become normalized. We accept long wait times because that’s how the system works. We tolerate outdated technology because we’ve become accustomed to it. We work around limitations rather than asking whether those limitations need to exist in the first place.
Having worked in these environments, I understand that meaningful change isn’t always easy. Established organizations have infrastructure, processes, and business models that have evolved over many years. But why should organizations continually have to adapt their operations to accommodate the limitations of their TPA? Shouldn’t the TPA be equally invested in understanding the customer’s business and finding ways to make things better? The industry shouldn’t become so comfortable with how things have always been done that it loses sight of what could be done differently.
Startups Have Something to Prove
A startup doesn’t have decades of history to lean on. It has to earn trust, demonstrate value, and give customers a reason to believe in what it’s building.
That can be a disadvantage, but it can also be a tremendous strength.
Every client matters. Every interaction is an opportunity to demonstrate value. Feedback can directly influence what a company builds, how it serves its customers, and where it goes next. When you’re working with a startup, you’re often not just buying a service. You’re helping shape what that service becomes.
I experienced this firsthand when I joined Yuzu. Being team member number seven meant stepping into an environment where we weren’t simply maintaining an established structure. We were helping build it. Every decision, customer relationship, and opportunity mattered. There was an incredible amount of responsibility, but also an opportunity to approach things differently from the beginning.
When an organization chooses to move away from what it has always known and gives a newer company an opportunity, there is an obligation to show up every day and prove that decision was worthwhile. That means listening, being responsive, following through on commitments, and being willing to have difficult conversations. We won’t always get everything right, but how we respond, learn, and improve matters. I see that responsibility as an advantage. It should push us to work harder, challenge ourselves, and never lose sight of the people who took a chance on us.
Partnership, Not Just Service
One of the most compelling reasons to consider a different approach is the opportunity to build better relationships.
For me, this has always been about more than delivering a service. It’s about how you show up for the people who trust you to deliver it. I believe clients and customers should become partners. They shouldn’t feel like another account, contract, or transaction. They should feel heard, valued, and involved in the relationship.
A TPA should want to understand its customers’ businesses, not just the administrative responsibilities outlined in an agreement. It should understand their challenges, the people they serve, their goals, and the operational realities that influence their decisions. True partnership means working toward shared goals, communicating openly, addressing challenges together, and recognizing that both organizations have a vested interest in the outcome. It also means being willing to listen when something isn’t working. Feedback shouldn’t be viewed as criticism to defend against. It should be an opportunity to understand, improve, and build something better.
In a growing organization, there is an opportunity to create relationships where communication doesn’t get lost in layers of bureaucracy. Leadership can remain accessible, problems can reach the people who can address them, and customer feedback can help shape meaningful improvements. When a company views its customers as partners rather than accounts, accountability becomes part of the relationship. The goal shouldn’t simply be to service an account. It should be to build a relationship where both organizations are better because of the partnership. That’s the kind of relationship I believe the industry should be striving for.
Technology Should Make Life Easier, Not More Complicated
Technology has transformed nearly every aspect of business, yet many organizations are still working with systems designed around yesterday’s needs. I’ve seen how technology can either make people’s jobs easier or create additional work. Legacy platforms often have layers of technology built on top of older infrastructure. New features are added, integrations become increasingly complicated, and users are expected to adapt to the system instead of the system adapting to them. A startup has an opportunity to approach technology from a different starting point.
But I feel strongly about one thing: Technology shouldn’t be built in a vacuum.
The people developing technology shouldn’t be the only ones deciding what it needs to do. The people using it every day and the clients depending on it should have a voice in that process. Claims processors understand where processing becomes complicated. Support teams know the questions members and providers repeatedly ask. Payment teams understand the challenges with reconciliation and reporting. Clients and brokers know what information they need and where existing processes fall short. Those perspectives matter.
Some of the best ideas don’t come from a boardroom or a development meeting. Sometimes they come from the person processing claims, answering member or provider questions, reconciling payments, or trying to find information that should have been readily available. Technology should solve real problems. It should eliminate unnecessary steps, reduce repetitive work, improve access to information, create better visibility, and make the experience easier for everyone involved. The goal shouldn’t be technology for technology’s sake. It should be less friction and better outcomes.
And this is where I have to give credit to the incredibly talented people I get to work alongside every day, particularly our engineering team. One of the things I appreciate most about working at Yuzu is having engineers who are engaged, talented, approachable, and genuinely collaborative. They work routinely with me and my team, listen to what we’re experiencing operationally, and are willing to jump in to make changes, enhancements, and improvements that help us do our jobs better.
Do I always get everything I ask for immediately? Absolutely not (much to my dismay 😂). Sometimes my requests find their way into what is now affectionately referred to as the “ice box” for a little while. But here’s the difference: those requests don’t simply disappear into a process, get buried under layers of approvals, or become another ticket that no one ever revisits. They get discussed, prioritized, revisited, and, more often than not, ultimately get done.
Having spent years in the traditional TPA environment, I can honestly say this is something I don’t take for granted. I can almost guarantee there are requests and technology enhancements I submitted at previous companies that are still sitting somewhere in a queue, waiting to be addressed years later. Not necessarily because the people involved didn’t recognize the value, but because the layers of processes, approvals, and competing priorities made getting things done incredibly difficult.
That is one of the differences I value about the environment we’re building. There is a level of accessibility and collaboration between operations and engineering that allows us to have conversations, explain what we need, work through solutions, and actually see progress. It’s not about expecting engineering to drop everything every time we have an idea. They have priorities, competing demands, and a responsibility to build technology that works for the entire organization.
It’s about having a team that is willing to listen, collaborate, and find a way to make improvements happen. That kind of relationship between the people using the technology and the people building it is incredibly valuable. And it’s a great example of what can happen when technology isn’t developed in isolation, but built through ongoing collaboration with the people who rely on it every day.
The Ability to Adapt Can Change Everything
In an industry that is constantly changing, the ability to respond matters.
Employers need answers. Brokers need information. Members expect timely service and access to their benefits. Providers want to know about the member benefits and claims submitted. Business needs evolve, and expectations continue to grow.
Large organizations may have extensive resources, but they can also have extensive processes. Startups often have fewer layers between an idea and its execution, and that agility can be a tremendous advantage. A customer identifies a problem. The company listens. A solution is explored, developed, tested, and improved.
That doesn’t mean every idea can be implemented immediately or every request should become a technology enhancement. Prioritization, resources, security, and scalability all matter. But there is something powerful about working with an organization that is willing to have the conversation, challenge its own assumptions, and explore a better way.
Startups will encounter growing pains. They won’t get everything right. But the willingness to learn, adjust, and evolve is just as important as having the perfect process on day one. Having worked in both environments, I appreciate the importance of experience and established operational knowledge. I also appreciate the energy and flexibility that come with building something new. I don’t believe those qualities have to be mutually exclusive. In fact, I believe the real opportunity is to bring industry experience into an environment that is willing to rethink how things are done.
But Isn’t Choosing a Startup Risky?
Absolutely. And that’s a consideration that shouldn’t be overlooked.
Changing TPAs is a significant decision. It affects people, processes, and the day-to-day operations of an organization. Choosing a newer company shouldn’t mean overlooking experience, security, financial stability, or operational readiness.
Organizations should ask the hard questions:
Who is behind the company, and what experience do they bring?
Does leadership understand the complexities of the industry?
Is the technology secure, reliable, and scalable?
Does the company have the resources to support customers as it grows?
Can it deliver on its promises?
Is there a clear commitment to service, accountability, and continuous improvement?
Those questions matter. Due diligence matters. Experience matters.
But there is another set of questions that deserves just as much attention: What is the cost of staying with the status quo?
How much time is lost to inefficient processes? How many employees spend hours working around outdated systems? How many opportunities for improvement are dismissed because changing existing infrastructure seems too difficult? What happens when service no longer meets expectations, technology isn’t keeping up with the needs of the business, or feedback goes unheard?
Those are risks, too.
Taking a chance on a new partner doesn’t mean making a decision without doing your homework. It means being willing to evaluate what’s available, ask the tough questions, and consider whether there may be a better way forward. Sometimes the biggest risk is assuming that what worked in the past will always be what’s best for the future.
The Future Doesn’t Have to Look Like the Past
When I look back at my career, I recognize that some of the most meaningful opportunities have come from being willing to step outside what was familiar.
I spent years working for established TPAs. I learned the industry, developed my experience, and gained an appreciation for the complexity of what we do. But eventually, I was willing to take a chance on something different.
Joining Yuzu as team member number seven wasn’t simply accepting a position at another company. It was choosing to be part of a team that wanted to challenge the way healthcare administration had traditionally operated. It meant stepping into an environment where we were building, questioning, learning, and evolving together.
There is something incredibly rewarding about being part of a team that believes there is a better way and is willing to put in the work to make it happen. I see talented individuals bringing different experiences and perspectives to the table, challenging assumptions, and working toward something bigger than any one individual. We have an opportunity to build relationships differently, approach technology differently, and challenge expectations that have become standard in our industry.
I don’t believe the conversation should be about startups versus legacy TPAs. There are established organizations doing excellent work, just as there are startups that still have a great deal to prove.
The conversation should be about what the industry needs next.
We need organizations willing to move forward rather than simply maintain what already exists. We need technology that simplifies the experience instead of adding complexity. And we need service models built around accessibility, accountability, and genuine relationships.
I believe in challenging the status quo because organizations should have options. They should be able to expect more from their partners, and customers should never feel they have to settle simply because they’ve always done business a certain way.
The future of this industry shouldn’t be determined solely by the companies that have been around the longest. It should be shaped by organizations willing to listen, innovate, take calculated risks, and continually ask how they can do better.
I’m not suggesting that choosing a startup guarantees a better experience or that established organizations don’t have a place in the future of healthcare administration. I’m suggesting that we should be willing to look beyond the name, the history, and the familiarity and evaluate what a company is actually bringing to the table.
Sometimes taking a chance isn’t about choosing the riskier option. It’s about recognizing that staying with what you know isn’t necessarily the safer choice.
Sometimes, the biggest risk of all is settling for the status quo.