Doug Monkhouse – Employer Direct Healthcare   

With half of all Americans getting healthcare through their employer, HR departments across the country are on the frontlines of two major challenges facing our country’s system – dramatically rising costs and inconsistent quality of care, particularly for the scariest moments when surgery or extended treatment might be necessary. 

These company leaders and the employee populations they serve are at the top of everyone’s mind daily, including Doug Monkhouse, Chief Legal Officer and Chief of Staff for Employer Direct Healthcare (EDH), and his team.  

It’s widely understood that in healthcare, a small portion of the population with the most complex needs drives most healthcare spending. As Monkhouse and the team at EDH know well, the same is true for employers, especially the self-funded organizations that EDH works with—companies that take on the full cost of their employees’ healthcare needs.  

According to EDH, 20 percent of employers’ healthcare costs are surgery-related, which inspired the development of EDH’s first product, SurgeryPlus. By focusing on the highest-cost, highest severity needs – things like surgery, cancer treatment, and other specialized care – EDH helps connect workforces to the best specialists close to home so they receive the best care at the lowest possible cost for them, as well as their employers.  

With the company since April 2019 as its Chief Legal Officer and Chief of Staff since January 2022, Monkhouse described how SurgeryPlus has been a major benefit for self-funded employers, their employees, and EDH itself. EDH’s core business is built around SurgeryPlus, and the product is the focal point not only of business growth— which has increased in size from 40 employees when Monkhouse joined to nearly 400 in under five years—but also his day-to-day tasks.   

“The vast majority of my time is spent on SurgeryPlus, which I enjoy because I know how much this service helps employers and employees—not just with actually paying for surgery, but also with providing a full spectrum of benefits and guidance to help navigate the very confusing and often complicated realm of healthcare,” Monkhouse said.     

The company reports that SurgeryPlus saves employers and employees up to 50 percent on surgical costs. Monkhouse said such savings are possible because “we’re driving value to providers by reducing the administrative burden typically associated with payors, so we can contract with best-in-class providers at lower reimbursement rates.”  

Of course, healthcare and benefits administration is heavily regulated, so Monkhouse and his team are focused on ensuring EDH operates compliantly. Beyond that, the legal team helps EDH grow its services and reach more clients by working on everything from developing broader commercial distribution through strategic partnerships to obtaining debt and equity financing.  

Innovative oncology   

Monkhouse also helped create and design EDH’s latest product, Cancer Care Direct, which offers complete support for cancer patients throughout their treatment journeys.   

“A cancer diagnosis can be terrifying and overwhelming, and my colleagues and I wanted to make that journey easier to navigate for patients and their families,” he told Vanguard. “Cancer Care Direct is the result.”   

Monkhouse and his team have played an integral role at every step of the process with Cancer Care Direct, ensuring the program is legally compliant and, thus, a viable solution for employers from a legal perspective.  

In collaboration with EDH’s leadership team, he also made several contributions to different aspects of the program, such as securing partnerships with solutions that provide access to expert medical opinions, thus offering a way for patients and their treating physicians to ensure they have a correct diagnosis before treatment is even considered. In its current state, among other benefits, Cancer Care Direct connects members with experienced oncology nurses and non-clinical personnel for everything from preferred access to cancer specialists to appointment and logistical coordination, to education relating to potential treatment, to emotional support, even for those who are now in remission.       

“Our goals with this project are clear in its motto, which reads ‘No one should face cancer alone,’” Monkhouse said.  

Care and career switches   

Projects like Cancer Care Direct take funding, and Monkhouse is involved in that as well. In fact, he’s recently worked on two capital rounds, which he said are significant and critical to the organization’s growth and success.  

The first of such events was a change of control transaction, where Serent Capital acquired EDH from Dundon Capital. In July 2021, he also led EDH’s legal team in a capital round led by Redmile Group, a healthcare-focused investment firm. And in December 2023, he oversaw an investment in EDH by Insight Partners, a global technology investor, bringing the company’s valuation to $1 billion. The purpose of these transactions was to provide capital for the expansion and enhancement of EDH’s products and bring best-in-class investor capabilities to bear for the future of the business.  

Monkhouse graduated from Texas A&M University and Baylor University School of Law.  After graduating from Baylor, Monkhouse worked with law firms until April 2019, when he joined Employer Direct Healthcare in his first in-house role. He brought years of experience with litigation and trials spanning various industries, including healthcare.   

“When I was approached about the opportunity at EDH, I was trying to decide the next steps in my career—and I’m so glad I stepped through the EDH door,” Monkhouse said. “The business is fast-growing, the people here are amazing, and every day, we’re driving better healthcare outcomes for employers and their employees across the nation.”   

View this feature in the Vanguard Spring III 2024 Edition here.