E=CUP as a framework for asking questions

E=CUP isn’t just an equation. It’s a framework for figuring out which questions to ask.

This week I walked through each variable — P (price), U (utilization), and C (caseload) — and what’s driving costs in each one right now.

Here’s what it looks like in practice.

A CFO who understands E=CUP walks into their next benefits review and asks:

What is our actual net drug spend after rebates and can we see the rebate contracts?

Who sets our provider reimbursement rates, and what’s our spread exposure?

What is our plan doing to manage U before claims happen, not after?

What does our enrolled population look like compared to last year — are we losing healthy employees?

These aren’t benefits questions. They’re financial oversight questions. They’re the same questions you’d ask about any major vendor relationship.

The reason most CFOs don’t ask them is that nobody ever showed them the equation.

Now you have it.

Question: If you could get a real, documented answer to only one of these next week, which one would you pick?

If someone in your network is writing a check for employee health benefits without asking these questions, send this their way.