Staying Put: Your Most Expensive Non-Decision
Today’s post is about a decision most buyers don’t think they’re making.
Not choosing a new PBM. Not evaluating a new model. But something quieter: choosing not to switch.
Because in workers’ comp, staying put often feels like the safest move. It just doesn’t always turn out that way.
The Story We Tell Ourselves
When the idea of switching comes up, the same concerns surface:
“Adjusters will be disrupted.”
“We’ll create noise with injured workers.”
“We’ll have to retrain teams on a new portal.”
“We’ll lose reporting capabilities we rely on.”
It sounds responsible. Thoughtful, even.
But if you listen closely, most of these aren’t operational risks.
They’re assumptions that haven’t been re-underwritten in years.
The Switching Cost Fallacy
Here’s the quiet truth:
Most switching costs are overstated.
And most staying costs are understated.
Let’s break that down.
Adjuster Turmoil
The fear: “Adjusters won’t adapt. Productivity will dip.”
The reality: Adjusters adapt faster than systems give them credit for—especially when the workflow is cleaner.
What actually creates turmoil isn’t change.
It’s friction: manual workarounds, inconsistent approvals, unclear pricing logic
If those exist today, staying doesn’t eliminate disruption. It just makes it familiar.
Patient Noise
The fear: “Injured workers will feel the change.”
The reality: Patients feel breakdowns, not backend transitions.
Delays. Confusion. Access issues.
If the underlying model improves: faster fills, better coordination, clearer communication. Then the “noise” doesn’t increase. It decreases.
Portal Retraining
The fear: “We’ll have to retrain everyone.”
The reality: Most teams are already underutilizing what they have.
Be honest: How many features in your current system are: never used, poorly understood, or quietly ignored?
Retraining feels heavy… until you realize you’re often retraining around features no one relied on to begin with.
Reports and Capabilities
This is the big one.
The fear: “We’ll lose reporting.”
The reality: You won’t lose reporting.
You might lose reports that don’t drive decisions.
Dashboards that look sophisticated…but don’t change behavior.
Metrics that track activity…but don’t explain outcomes.
Over time, organizations accumulate reporting the same way they accumulate subscriptions: It’s there. It looks important. But no one would notice if it disappeared.
The Window Dressing Problem
This is where it all converges.
Switching costs are often built on: legacy workflows, unused tools, assumed dependencies, and “What if” scenarios.
It’s operational window dressing.
And it’s powerful—because it makes staying feel rational. Even when it isn’t.
What Doesn’t Get Measured
While all of this is being debated, something else is happening in parallel.
Quietly. Consistently.
Scripts routed through suboptimal channels
Pricing tied to benchmarks that don’t reflect reality
Specialty decisions made without full visibility
Leakage that never quite triggers a red flag
Nothing breaks. But nothing optimizes either.
And over time, that gap compounds.
The Real Cost Curve
Switching has a cost. No one disputes that.
But it’s: Finite. Time-bound. Visible
Staying has a cost too. It’s just: Recurring. Compounding. Hidden in the baseline
One is a line item. The other is a curve.
A Simple Reframe
Instead of asking:
“Can we afford to switch?”Ask something more precise.
Ask Yourself This: What is the true cost of switching?
Not the assumed version.
Not the inherited narrative.
The true cost:
Of retraining
Of transition
Of short-term disruption
Then compare it—honestly—to the cost of:
Another year of suboptimal routing
Another cycle of opaque pricing
Another set of reports that don’t drive action
You might find something uncomfortable.
It may be costing you more to stay put than to move.
Final Thought
In workers’ comp, inertia doesn’t feel like a decision. But it is.
And like most decisions in this space, it compounds.
If you need to rethink your switching costs, let’s get started.
About P4P
A Strategic Dose of Clarity in a Noisy PBM Market
Written by Prodigy CEO, Del Doherty, P4P delivers sharp, consultative insights for decision-makers who are tired of legacy models, hidden costs, and passive vendors. Each piece is a prescription—cutting through the noise to reveal what actually drives performance in pharmacy benefit management. No fluff. No spin. Just insight that pays off.
