Self-Funded With Spencer

Does bone-on-bone contact always lead to pain? What's the best way to get good, new solutions in the hands of brokers? How many MSK surgeries are really necessary?

Chris Hamilton, Heidi Ojha, and Mark Testa joined me in studio to answer those questions and many more in this special bonus episode of Self-Funded with Spencer, The MSK Roundtable.

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"I always knew there was more. I always knew there was a different dimension to what this personnel or HR thing was." - Monica Panetta Monica Panetta, Chief People Officer at ParetoHealth (a show sponsor and the company I work for), joined me for an evening podcast in studio as we talked all things HR/People, starting with why the industry has moved away from saying HR. Monica’s so well-versed in the field that she actually started the HR program at her college as she was attending it, and the curriculum is still taught today. We talk how she got started in the field, how the field has evolved post-COVID, and how she made her way to Pareto. Join us this week to find out a bit about Pareto, and a lot about what it means to be a Chief People Officer. Chapters: 00:00:00 Meet Monica Panetta 00:01:38 Employee-Centric Leadership: How HR Has Evolved 00:02:38 Transitioning From “HR” to “People” 00:05:00 Getting Started In HR 00:13:16 Monica’s Career Journey 00:21:31 Strategic Benefits Management As An HR Employee 00:23:31 Empowering Employees Through Mental Health Support Programs 00:24:32 Promoting The EAP Program Internally 00:40:13 Recognizing Every Employee’s Journey 00:41:39 Cultural Compatibility Evaluation In The Hiring Process Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words: #ChiefPeopleOfficer #HRterminology #CareerExploration #FinancialAcumen #EmployeeAssistancePrograms #UtilizationStrategies #EmployeeExperience #Onboarding #CultureFitAssessment #HRroles #WorkplaceWellness #JobSatisfaction #selffunded #podcast Chief People Officer, HR terminology, Career Exploration, Financial Acumen, Employee Assistance Programs, Utilization Strategies, Employee Experience, Onboarding, Culture Fit Assessment, HR roles, Workplace Wellness, Job Satisfaction, self funded, podcast

 "I think the more questions the employer asks, and just the deeper that they're willing to think about this and have already thought about it, the more they're able to buy into this mission." - Russell Pekala

Russell Pekala, co-founder of Yuzu Health, joined me in studio for this week’s episode focused on controlling pharmacy costs and emergency claims. 

Yuzu Health is a startup in the TPA space aiming to change how the claims process work. Rather than having the member get care and then deal with lowering costs after the fact, Yuzu pre-adjucates claims when possible, issuing a credit card to members to pay for care and avoiding huge bills on the backend. 

In addition to the claims talk, Russell and I chatted about his Harvard days, what founding a dating app was like, and the ramen-related health accident that pushed Russell into the healthcare startup space. 

Chapters:

0:00 - Meet Russell Pekala

5:53 - Working On A Dating App At Harvard
08:26 - The Art and Science of Stop Loss Insurance
18:47 - Yuzu's Innovative Startup Health Insurance Solution
20:44 - How Did Yuzu Get Started?
21:45 - Improving Healthcare Transparency and Accessibility with Yuzu
28:48 - Navigating Pharmacy Costs with SmithRX
32:51 - Revolutionizing Emergency Claims in Healthcare
39:26 - Employers Seeking Alternative Healthcare Approaches
54:26 - Revolutionizing healthcare through predictive wearables

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#healthcare #healthinsurance #startups #technology #costcontrol #pharmacy #employers #predictivedata #wearables #futureofinsurance #selffunded #podcast

healthcare, health insurance, startups, technology, cost control, pharmacy, employers, predictive data, wearables, future of insurance, self funded, podcast

“To me, a private equity firm should never look at a healthcare vertical and say, God, there's opportunity there. That means that there's profit exploitation to be had in those areas.” - Taylor Rogers

Taylor Rogers, former professional baseball pitcher turned insurance consultant, joined me this week for a podcast focused on profit exploitation in the current healthcare system, and what we need to do as an industry to bring back competition and lower prices. 

There are a huge number of people in this space who used to be college or professional athletes, so I was excited to hear what led to Taylor’s baseball career and what also led him to insurance. 

Competition is an inherent component of capitalism, one that leads companies to try to lower prices as much as they can to appeal to consumers, but it’s incredibly absent from this field. Join Taylor and I this week on Self Funded as we try to figure out why. 

Chapters:

0:00 - Meet Taylor

07:38 - Consistency, in Baseball and Comedy
09:36 - The Importance of Failure in Growth
12:50 - The Evolution of Insurance Consulting Strategies
18:00 - bridging the gap with accessible communication
23:28 - Navigating Risk Management Challenges in Insurance
25:01 - Guiding employees through the healthcare system
31:26 - Limitations of 24/7 emergency care navigation
35:16 - Strategic guidance and business acumen in consulting

46:29 - The Potential of Direct Primary Care

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#insurance #healthcare #consulting #businessstrategy #privateequity #affordablehealthcare #riskmanagement #selffunding #carenavigation #consultingpractice #podcast #selffunded

insurance, healthcare, consulting, business strategy, private equity, affordable healthcare, risk management, self funding, care navigation, consulting practice, podcast, self funded

“You can have the same provider, same treatment, two different locations, different outcomes.” - Gentry Lynn

Gentry Lynn, VP at Healthcare Bluebook, joined me this week to discuss what it means to actually make an impact in this industry, why there’s so much cost variance between locations, and how we can more effectively engage members to use new solutions.

One of the key points of our discussion was that there are actual health outcome and cost ramifications to which location patients get their care from, even if the provider is exactly the same. 

The impact of what we do is a frequent topic of this podcast, and in this episode we dive deep into what it means to try to make positive change in such a huge and frequently old-fashioned industry.

Chapters:

0:00 - Meet Gentry

02:49 - Gentry Lynn's Journey into the Insurance Industry
19:24 - Remote Collaboration and Specialization in Our Industry
23:19 - Healthcare Cost and Quality Transparency Tool
31:19 - The Impact of Medical Cost Transparency
37:18 - Evaluating Doctors for Optimal Medical Care
46:11 - Cost Variance By Location
51:59 - Personalized Communication leads to Member Engagement

54:05 - Surprising Disparities in Healthcare Procedure Costs

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#healthinsurance #healthcare #bluebook #employersolutions #costandquality #centersofexcellence #employermindsets #dataintegration #claimvalidation #costvariance #podcast #selffunded

health insurance, healthcare, bluebook, employer solutions, cost and quality, centers of excellence, employer mindsets, data integration, claim validation, cost variance, podcast, self funded

“It's like the Wizard of Oz, I think, or The Matrix. You have this veil that as the participant in it for so long, you just don't think about your benefits. But I think when you kind of peel back the curtain and you're looking at the greed of it and how everyone is getting paid on people being sick, it's gross. And I don't vibe with it.” - Durrell Finch

Anyone who listens to the show should know by now that I’m a huge proponent of personal wellness, healthy eating, and exercise, which is why I was super excited to have Durrell Finch join me for this week’s episode. 

Durrell is a former fitness trainer and the VP of Business Development for BioCoach, a company focusing on employee wellness through end-to-end obesity and diabetes care and prevention. 

We discussed some simple and practical ways to better structure workouts, then jumped into our main topic: GLP-1s, the new class of weight loss drugs, and how employers should assess their role in wellness.

Join Durrell and I on this week’s wellness-focused episode of Self Funded, and stick to the end to see if I can properly stand up from a criss-cross position!

Chapters:

0:00 - Meet Durrell

04:52 - The Healing Power of Movement

16:49 - Improving Performance through Mindfulness and Biomechanics
17:40 - Navigating Covid Challenges As A Fitness Trainer
30:46 - Biocoach: Data-driven Wellness with Personalized Support
38:05 - Fostering Camaraderie and Personal Growth in the Workplace
42:01 - Affordable and Accessible Healthy Eating Strategies
48:50 - The Role of Muscle in Long-Term Weight Loss
51:06 - Promoting Sustainable Weight Loss through Education
53:28 - Structured Weight Loss Program with Drug Progression
58:12 - Financial Implications of Healthcare Choices
01:06:50 - Revolutionizing Health and Wellness with Fitness Tracking

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#ozempic #weightlossdrugs #movement #exercise #wellness #health #fitness #psychology #personalgrowth #mobility #legstrength #biocoach #healing #selffunded #podcast

Ozempic, Weight Loss Drugs, Movement, Exercise, Wellness, health, fitness, psychology, personal growth, mobility, leg strength, biocoach, healing, self funded, podcast

"Compliance does not have to be a burden. It doesn't have to be hard. It can be a value differentiator and an opportunity to really help people." - Jen Berman

Jen Berman joined me this week to close out our trilogy of compliance episodes. We focused on why regulations exist, the purpose of recent legislation like the CAA, and why it’s important for consultants to learn the compliance process.

Jen is the CEO of MZQ Consulting (not an acronym, as we discuss in the episode), a leading provider of compliance solutions in the industry. Recent compliance has shifted the burden onto employers to make sure their plans are compliant, including making sure that their mental healthcare is in parity with normal healthcare. 

As Jen said on the episode, compliance is typically viewed as a burden, but for consultants, it shouldn’t be: it’s an opportunity to differentiate yourself in the market and provide a next level of service to employers.

Join Jen and I this week for another compliance-focused episode of Self-Funded.

Chapters:

0:00 - Meet Jen

2:23 - The Impact of ACA on Healthcare Industry
17:24 - Anticipating Gag Clauses: CAA Compliance Solutions
19:43 - Mental Health Care Should Equal Health Care
27:02 - Employer Investigations
36:23 - Tracking Money Flow and Compliance
41:57 - Gag Clauses and Restricted Access to Plan Information
49:22 - The influential role of compliance professionals
54:53 - The importance of regulatory schemes in healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#ACA #CAA #healthcare #compliance #regulations #AffordableCareAct #mentalhealthparity #governmentinvestigation #prescriptiondrugdata #gagclauses #complianceprofessionals #selffunded #podcast

ACA, CAA, healthcare, compliance, regulations, Affordable Care Act, mental health parity, government investigation, prescription drug data, gag clauses, compliance professionals, self funded, podcast

"When consumers understand that they can get the same level of care at half the price, they feel good about making that decision." - Josh Schreiner

“We're actually going to collapse that concept entirely. Everyone's in network from your perspective, from the consumer, from the patient perspective." - Michael Mather

Continuing from last week’s theme of compliance and regulation, Josh Schreiner, Chief Product Officer, and Michael Mather, General Counsel, of HealthEZ joined me for a discussion on the effects of the No Surprises Act on the healthcare industry as a whole, and how it affects consultants as they work with employers.

At HealthEZ, Josh and Michael have been looking ahead to the future of healthcare and how the recent regulations have impacted that, including a returned focus to consumer decisions in their own healthcare and an increased focus on employer compliance. For consultants, these are particularly important topics as consultant responsibilities shift in response to the legislation.

Join Josh, Michael, and I as we break down the No Surprises Act, offering our insights and hopefully some practical guidance on navigating this crucial piece of healthcare legislation.

Chapters:

0:00 - Meet Josh & Michael

1:23 - Empowering Consumer Decisions through Healthcare Transparency

5:44 - Navigating Healthcare Compliance

16:22 - Protecting Patients Through The No Surprises Act

23:19 - The High Volume of Disputes

30:39 - Increasing contract disputes impacting healthcare reimbursement

38:05 - Transparent Healthcare Information

40:50 - The Impact of Transparent Healthcare Pricing

50:30 - Gag Clause Attestation and Compliance Challenges

58:34 - Balancing Guidelines and Innovation in Healthcare

1:04:55 - Leveraging Wearables and Data for Personalized Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: #healthcare #transparency #compliance #innovation #selffunded #medicalcosts #consumerinformation #futureofhealthcare #wearables #datadriven #nosurprisesact #regulation #podcast Healthcare, Transparency, Compliance, Innovation, Self Funded, Medical Costs, Consumer Information, Future Of Healthcare, Wearables, Data Driven, No Surprises Act, Regulation, Podcast

“The CAA was the most significant piece of healthcare legislation that we've had since the ACA.” - Sarah Borders

Healthcare compliance, especially post-CAA, can be a complex thing for employers to navigate. There’s an increased level of scrutiny on employers, with heavy fees for those who don’t comply. 

This week on Self-Funded with Spencer I’m joined by Sarah Borders, co-founder of Benefits Compliance Solutions. Here are a few key takeaways for consultants:

• Understanding compliance: Navigating the complex regulations and avoid costly mistakes.

• Turning compliance into an advantage: Discover how you as a consultant can leverage compliance as a prospecting tool, saving clients from lawsuits, penalties, and headaches.

• Embracing the benefits of regulation: Understand the purpose of the CAA and how it exposes bad practices, ultimately improving healthcare for everyone.

Join us this week on Self-Funded with Spencer to learn how to not get sued.

Chapters:

0:00 - Meet Sarah Borders

6:37 - Sarah’s Journey To Compliance Expertise

14:05 - The Shift Towards Data-Driven Compliance

17:33 - Remote Work As An Entrepreneur

27:01 - Effective Communication = Effective Information

34:57 - Legal Repercussions Of Cobra Compliance

41:34 - Group Health Plan Compliance

46:20 - Yearly Attestation

54:04 - The Impact Of Regulations On Transparency

1:01:21 - Empowering Clients and Consultants

1:04:38 - The Impact Of CAA On Group Health Plans

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#insurance #compliance #industrytrends #ACA #caa #levelfundedplans #Cobra #CobraCompliance #grouphealthplan #ConsolidatedAppropriationsAct #attestation #regulations #consulting #futureofcompliance #healthcarecompliance #selffunded #selffunding #podcast

Insurance, Compliance, Industry Trends, ACA, CAA, Cobra, Cobra Compliance, Group Health Plan, Consolidated Appropriations Act, Attestation, Regulations, Consulting, Future Of Compliance, Healthcare Compliance, Self Funded, Self Funding, Podcast

"I think our industry is craving some disruption - and it needs it." - Jack Crotty

What does it actually mean to disrupt the health insurance industry? 

Jack Crotty, the Director of Business Development of Adyptation, joined me in studio this week for a discussion on the innovative solutions he’s bringing to the consulting world, including pharmaceutical sourcing and specialized disease care that brings incredible care to employees and day one savings to the employers who pay for it. 

As Jack says in the episode, Adyptation’s primary goal is to act as a “Robin Hood” figure in the industry, taking the power from the large corporations and giving it back to the people the industry is meant to serve, and anyone who listens to the show knows that’s a mission I can get behind.

Jack and I also had a fascinating discussion on what the role of wearables should be in tracking patient progress. When utilized correctly, wearable data allows physicians to assess patient progress as they work towards their personal health goals. 

Join us this week for a very future-focused episode of Self-Funded with Spencer.

Chapters:

0:00 - Meet Jack Crotty

06:46 - Navigating Approval Processes

10:23 - The Power of Being a Startup Disruptor
18:43 - Specialty Disease Management and Cost Containment
23:11 - Saving Employers 30% Through Sourcing
30:19 - Tracking Health with Wearable Devices
35:32 - Streamlining Employer Benefits with Pass-Through PBMs

37:07 - Strategic PBM Partnerships for Seamless Growth

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#InnovativeSolutions #InsuranceConsulting #Disruption #Disrupters #Startups #SpecialtyDiseases #PharmaceuticalSourcing #ClinicalSupport #AlignedIncentives #Diet #Wearables #SelfFunded #SelfFunding #Podcast

Innovative Solutions, Insurance Consulting, Disruption, Disrupters, Startups, Specialty Diseases, Pharmaceutical Sourcing, Clinical Support, Aligned Incentives, Diet, Wearables, Self Funded, Self Funding, Podcast

"There's no reason you can't make content.There's no excuses. Just get started. Because it could open opportunities you don't even know." - Jake Rushton

Jake and I can both honestly say that we would not be where we are in our careers today without social media, but for many of those who tune into the show, getting started with producing content can be super intimidating. How do you film reels or podcasts? Do you need a bunch of super expensive equipment right away? And, if you put the time/money in, what’s truly the ROI?

Jake Rushton is a 401k and retirement planner who in recent years has also started social media strategy consulting through his company Zeke Digital. He’s mastered the art of starting a social media presence, creating content catered to your goals, and turning your likes and followers into clients. 

Of course, in the social media world, ROI isn’t immediate; social marketing is a marathon, not a sprint. But, if you invest your time and energy wisely, you can open up opportunities in your career you’ve never even thought of. 

Chapters:

(00:06:01) Running A Marathon At Twelve (!)

(00:12:54) Managing 401(k)s

(00:21:31) The Transformative Potential of Content Creation

(00:29:33) Building Trust In You And Your Brand

(00:32:30) Overcoming Insecurity and Embracing Imperfection

(00:40:01) Efficient Video Production and Distribution Strategy

(00:45:40) The Power of Tailored Content on Social Media

(00:51:07) Optimizing Your LinkedIn Profile for Success

(00:59:01) Leveraging Content Creation for Effective Communication

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#contentcreation #trustbuilding #marathonrunning #crosscountryrunning #401k #digitalmarketing #batchcontentcreation #linkedInprofile #selffunded #selffunding #podcast

Content Creation, Trust Building, Marathon Running, Cross Country Running, 401k, Digital Marketing, Batch Content Creation, LinkedIn Profile, Self Funded, Self Funding, Podcast

“I think we're now at a point where we as a society are recognizing we can't wait until it gets bad enough. And how do we get people into care sooner?" - Megan Rozanski

I wanted to close out January with a focus on mental health and how to continue breaking down the stigma surrounding it, and Megan Rozanski was gracious enough to join me in the studio to do just that. 

Expanding access to and improving the delivery of healthcare have been two key values of the podcast since the beginning, and those objectives are no less important in the mental health sphere. 

How did COVID impact the future of mental health care? What pushed Megan to leave her corporate career and take on the uncertainties and challenges of founding a startup in the industry? And what can we do to improve access to care? 

Join us to learn the answers to all of those questions and more, this week on the Self Funded podcast!

A few of Megan's sources:

Increased comorbidities and total cost of care: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Integrated-Care/Milliman-Report-Economic-Impact-Integrated-Implications-Psychiatry.pdf Share of employees in poor mental health who couldn't get into treatment: https://www.kff.org/private-insurance/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/ Increased likelihood of going out of network to see a behavioral health provider versus primary care: https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p

Chapters:

(00:01:41) The Entrepreneurial Journey in a Mental Health Startup

(00:09:41) Supportive Work Environments for Mental Health

(00:14:22) Revolutionizing Therapist Matching

(00:20:56) Personalized Therapy Matching Algorithm

(00:29:45) Reducing Barriers and Expanding Access to Mental Health Care

(00:35:52) Improving Mental Health Care for Self-Funded Employers

(00:49:12) Underserved mid-sized employers seeking mental health access

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#mentalhealth #startup #founder #accessibility #therapy #selfcare #workplacewellness #destigmatize #employeewellbeing #healthtech #HealthcareIndustry #SelfFunding #SelfFunded #Podcast

Mental Health, Startup, Founder, Accessibility, Therapy, Self Care, Workplace Wellness, Destigmatize, Employee Wellbeing, Health Tech, Healthcare Industry, Self Funding, Self Funded, Podcast

"Whereas the current structure pits [employers, doctors, and patients] against each other, with Direct Primary Care, we all want the same thing." - Dr. David Cameron

For Dr. David Cameron, DPC (direct primary care) isn't just another health insurance acronym; it’s a revolutionary approach to delivering healthcare that has transformed his role as a physician.

Beyond incorporating DPC into his practice, David, in his capacity as the Chief Medical Officer at Hint Connect, is actively working to expand the reach of direct primary care to as many practices as possible. His mission is clear: aligning the interests of employers, patients, and doctors for a more cohesive healthcare system.

I had the pleasure of speaking with David to gain some insight into the physician's perspective on direct primary care; how it’s not just more cost-effective, but also an efficient and convenient way to provide healthcare. Join us on this DPC-themed episode of Self Funded for an enlightening conversation about the future of healthcare—you won't want to miss it.

Chapters:

(00:04:19) Personalized Healthcare for Longevity and Well-being

(00:14:12) Membership-based Primary Care with Unlimited Access

(00:26:25) Decrease in HIV and Tuberculosis Cases

(00:33:09) Streamlining Onboarding and Ensuring DPC Success

(00:42:41) Text-Based Communication in Direct Primary Care

(00:47:10) Comprehensive and Convenient Healthcare Services

(00:55:10) Challenges and Opportunities in Direct Primary Care

(00:58:33) Streamlining Onboarding for Physicians Starting DPC Practices

(01:00:56) The Surge of Direct Primary Care

(01:07:08) Transformation of healthcare through direct primary care

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: 

#directprimarycare #healthcare #costeffective #accessibility #selffunding #physician #primarycare #transformation #healthylifestyle #healthcareindustry

Direct Primary Care, Healthcare, Cost Effective, Accessibility, Physician, Primary Care, Transformation, Healthy Lifestyle, Healthcare Industry, Self Funding, Self Funded, Podcast

"The only thing that will fix healthcare is restoring the doctor patient relationship without anybody in between it." - Emma Fox

Emma Fox joins me on this special pre-YouPowered Symposium episode to talk about her healthcare journey, from moving to America and discovering just how broken our system was for the first time to recently meeting with the President to discuss what needs to be done. 

Emma’s early experience with medical debt and medical bankruptcy inspired her huge passion for transparency and change in this industry. We talk about what can be done in the current system, what needs to be torn down and rebuilt, and how helping people on Reddit is playing a small part in getting more people aware of what needs to be done.

My conversation with Emma Fox not only underscores the urgency for transformative changes in healthcare, but also the impact that personal narratives and direct doctor-patient relationships have in shaping a healthier, more just future for us all.

Chapters:

(00:00:28) The Importance Of Physical Fitness As We Age

(00:06:34) Dealing With Overwhelming Medical Debt

(00:10:10) Becoming A First-Time Entrepreneur

(00:17:00) Creating a Transparent and Inclusive Healthcare System

(00:20:51) Restoring the Doctor-Patient Relationship: DPC for All

(00:24:39) Optimizing health insurance for cost reduction

(00:29:53) Understanding the distinction between healthcare and health insurance

(00:35:25) Breaking down healthcare jargon for better understanding

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: Healthcare Reform, Transparency, Physical Fitness, Healthcare Advocacy, Medical Debt, DPC For All, Healthcare Education, Self Funded, Health Insurance Podcast

"If you show me the incentives, I'll show you the outcomes." - David Contorno

"I want to fix the healthcare system. My mission ended up being to correct the injustices I find in the healthcare system as I find them. And that's what I do every single day." - Emma Fox

On this bonus episode of Self Funded With Spencer, I sat down with David Contorno and Emma Fox for this bonus episode focusing on how their aligned views on the healthcare landscape led to their marriage and their mutual business ventures. 

We dive into how David started in this industry at the age of 12 (!), how the vision of the YouPowered Symposium came to life, and what it’s like to be married to your business partner.

Be sure to check out this week’s full episode with David Contorno, and next week’s episode with Emma Fox.

For more information on the YouPowered Symposium, check out YouPoweredSymposium.com.

Chapters:

(00:04:05) Passionate For Change

(00:09:00) Making Gradual Changes for Long-Term Health

(00:13:25) Correcting Healthcare Injustices: Emma and David's Mission

(00:16:13) Ethical Insurance and Transparent Health Consulting

(00:20:07) Creating Lasting Impact in Healthcare Discussions

(00:31:30) Realignment for Health and Well-being in Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: Healthcare Reform, Transparency, Health Insurance Industry, Healthcare Advocacy, Health And Wellness, Healthcare Industry, Misaligned Incentives, Healthcare Priorities, Self Funded, Health Insurance Podcast

"If we can take that [financial] anxiety away from them to where they can focus on their health, that's our mission, that's our cause. That's what we want to do." - Brett Morris

Brett Morris joins me on the podcast for a conversation revolving around the Samaritan Fund Program, which he developed to help those individuals and families who have been physically and financially devastated by a medical diagnosis. 

He directly works with employers and employees, helping to mitigate high-cost medical expenses on the employer’s end while enabling them to help their employees when they most need it.

An interesting side effect of the Samaritan Fund is that it enables employers who would otherwise go fully insured due to specific high-cost claims to afford self funding their business.

Join us on today’s show as we talk about the human impact of the Samaritan Fund and Brett’s unique approach to helping employees and employers. 

Chapters:

4:53 - What Is The Samaritan Fund?

10:26 - The Role of The Samaritan Fund in Employee Benefits

23:55 - Connecting Employers and Individuals in Need

31:04 - Financial Hardship Caused by High Cost Prescription Drugs

35:16 - Paycheck Donations: Empowering Employees to Give

42:21 - Reducing Expenses through Alternative Healthcare Plans

52:57 - Transparent Pricing: Empowering Consumers in Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: Employee Benefits, Financial Relief, Employer Support, Helping Those In Need, Good Samaritan, Medical Costs, Prescription Drugs, Giving Back, High Cost Claims, Medical Claim Relief, Risk Mitigation, Healthcare Costs, Innovative Solutions, Self Funded

In this special episode of Self-Funded with Spencer, I am joined by my friend Seth Denson for my first ever live version of the podcast through LinkedIn Live.

This episode was previously recorded on 12/20/23, but I wanted to make sure that those who missed it on LinkedIn, still had an opportunity to watch and listen.

Seth is the Head of Employee Benefits at Acrisure and he also features daily as a sought after business and market analyst for Fox News, CNN, NewsMax, OANN and more.

In this spirit of an AMA, no question was off limits, so we covered things like:

Our Hair Routines

• Seth's Media Life
• Whether we wear makeup!
• The role of Wellness Benefits
• Thoughts on RFP Software
• ParetoHealth (Captives)
• Seth's time working at a concert venue
• Our favorite bands to see live
• Our 3 favorite books
• And more!

Social Links:

Self-Funded's Channel - https://www.youtube.com/ @SelfFunded

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Advanced Medical Strategies - Stacy Borans - Founder of AMS

Stacy Borans is a seasoned expert in healthcare technology and data analysis, with a robust background in medical cost management.

As a key player at Advanced Medical Strategies (AMS), she has been instrumental in developing software solutions for payment accuracy, risk assessment, and business intelligence in the healthcare industry. Her perspective on healthcare technology and data analysis in medical cost management is shaped by her experiences at AMS, where she noticed excessively high bills during medical reviews and saw an opportunity to work on the financial aspect of cost management.

Stacy advocates for transparency in chargemaster pricing and cash pricing, and emphasizes the importance of reference-based pricing. She believes that these strategies can help determine the relevant charge for medical services, although she acknowledges that it may not always result in the lowest price.

Join Spencer Smith and Stacy Borans as they delve deeper into this topic on the next episode of the Self Funded podcast.

Chapters:

00:01:08 Creative cocktail concoctions

00:06:46 AMS: Innovating Healthcare Management Solutions

00:10:43 Understanding the Financial Impact of Self Funding

00:16:21 Shaping the Future of Healthcare Cost Containment

00:21:13 Healthcare Solutions for Complex Medical Cases

00:27:24 Catastrophic Diagnoses Cost Projections Software

00:33:09 Comprehensive Risk Assessment and Pricing Tool

00:40:38 Achieving Transparency in Healthcare Decision-Making

00:46:32 Analyzing Group Risk Profiles Using Census Data

00:56:26 The Impact of AI on Healthcare Diagnoses

Key Links for Social

Self-Funded's Channel - https://www.youtube.com/ @SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Listen on Spotify for Podcasters - https://podcasters.spotify.com/pod/show/spencer-harlan-smith

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: Medical Strategies, Claims Strategies, Data Analytics, Business Intelligence, Business Intelligence Software, BI Software, Claims Analytics, Insurtech Software, Software for Underwriters, Systems for Carriers, Software for Insurance Carriers, Technology for Insurance, Technology for Insurance Brokers, Tech for Insurance Consultants, Tech for Healthcare, Software for Doctors, Software for Third Party Administrators

Josh Honaker is a seasoned pediatrician from South Central Kentucky, renowned for his expertise in integrating telehealth and education in pediatric healthcare.

He currently serves as the CEO of Parent MD, a platform that embodies his belief in the necessity of Telehealth and education as solutions to common frustrations and disconnects in pediatric healthcare.

Dr. Honaker's perspective is shaped by his experiences with time constraints and high patient volumes, which often leave parents feeling frustrated and uninformed.

He sees Telehealth and education as vital tools to improve healthcare access and provide parents with reliable information and resources. Honaker envisions Parent MD as a platform that unites Telehealth partners, educational content, and a supportive community to enhance the medical home and provide comprehensive care for children.

Join Spencer Smith and Dr. Josh Honaker on this episode of the @SelfFunded with Spencer podcast to delve deeper into this innovative approach to pediatric healthcare.

Key Words: Telehealth, Direct Primary Care, DPC, Pediatrics, Pediatrics Telehealth, Parents, Education for Parents, Community for Parents, Resources for Parents, Employee Benefits for Parents, Healthcare, Employee Benefits, Benefits Brokers, Insurance Brokers, Insurance Consultants, Employer-Sponsored Healthcare, Innovations in Healthcare

Key Links for Social

Self-Funded's Channel - https://www.youtube.com/ @SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Listen on Spotify for Podcasters - https://podcasters.spotify.com/pod/show/spencer-harlan-smith

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Chapters:

00:00:00 Virtual Pediatrician Partnership for Holistic Childcare

00:03:57 The Impact of Mentorship on Choosing Pediatrics

00:14:56 Entrepreneurial Pediatric Care: A Unique Approach

00:21:44 Virtual consultations for comprehensive pediatric care

00:28:58 "Comprehensive Digital Resource for New Parents"

00:37:39 Expanding direct-to-consumer model to employers

00:43:48 Future plans for personalized nutrition education

00:46:22 Transforming Healthcare Delivery for Cost-Effective Care

00:52:11 Revolutionizing Healthcare with AI

00:56:11 Advancements in healthcare for optimal human health

Recruit & Retain with Employee Benefits - Kyle Minick

The evolving employer market is placing a greater emphasis on HR policies, benefits, and healthcare transparency. In this episode of the podcast "Self Funded" hosted by Spencer Smith and featuring Kyle Minick, the importance of these factors in talent management strategies was discussed.

Traditionally, financial compensation has been the primary focus for employers when it comes to attracting and retaining talent. However, surveys have consistently shown that compensation is not the top priority for employees. Instead, factors such as flexibility and paid time off are often cited as more important. This highlights the need for employers to look beyond monetary rewards and invest in HR policies and benefits that foster a supportive work culture.

Creating a sense of value among employees is crucial for retaining them. This can be achieved through leadership that demonstrates emotional attachment and loyalty. Employees want to feel that their employer cares about their success and well-being. HR policies and fringe benefits play a significant role in creating this sense of value. Offering assistance with buying a home or expanding financial futures are examples of how employers can show their commitment to their employees' long-term well-being.

The insurance industry is also evolving to offer creative and tangible business solutions. Benefits are a major expense for businesses, and insurance companies are recognizing the need to go beyond traditional coverage. They are now focusing on HR policies, fringe benefits, and talent attraction and retention. Summit, a company specializing in benefits, insurance, and investments, is leading the way in serving businesses of all sizes, with a particular interest in blue-collar companies. They are also taking steps to address the high costs of specialty drugs through new pharmacy initiatives.

Chapters:

(00:00:08) Podcasts and Education in Employer Market

(00:01:24) Creating a Culture of Employee Satisfaction

(00:06:05) Creating a Supportive Environment for Employee Retention

(00:10:09) Kyle's Journey in the Insurance Industry

(00:16:00) Innovative Solutions in the Insurance Industry

(00:24:52) Specialized Benefit Solutions for Businesses of All Sizes

(00:30:43) Challenges and Solutions for Blue-Collar Companies

(00:46:26) Pharmacy Initiatives: Addressing Specialty Drug Costs

(00:51:49) Unveiling the Elusive Healthcare Expenses

(00:58:08) Disruptive Innovation for Positive Change

From Military Service to Employee Benefits - Two Veterans' Journey into Healthcare

Transitioning from military service to civilian life can be a daunting task for some veterans. However, with the right support and guidance, veterans can find fulfilling careers in various industries.

One such industry is insurance consulting, which offers a unique blend of strategic thinking, problem-solving, and client management. In a recent episode of the podcast @SelfFunded with Spencer, hosted by Spencer Smith and featuring Cliff Favors and Winston Elliott, the topic of veterans transitioning to civilian careers in insurance consulting was explored in depth.

Networking and Support: Key Factors for Success

One of the key takeaways from the episode was the importance of networking and support for veterans transitioning to civilian life. Cliff Favors and Winston Elliott, both veterans themselves and employees at Lockton, emphasized the value of reaching out to others who have already made the transition. They highlighted the Houston veteran community as an excellent resource for connecting with like-minded individuals and gaining insights into different industries.

The Rewards of the Benefits Industry

Despite its reputation as a potentially dull field, the benefits industry, particularly insurance consulting, offers rewarding opportunities for veterans. Cliff Favors mentioned that the benefits industry is often misunderstood and under-appreciated. He emphasized that the industry plays a crucial role in solving people problems rather than just crunching numbers. By focusing on the human aspect of business, insurance consultants can make a positive impact on the lives of employees and their families.

Lockton: A Trusted Partner in Insurance Consulting

Lockton, a privately held insurance broker, stands out as a company that prioritizes its clients' interests. Winston Elliott highlighted the unique advantage of being privately held, as it allows Lockton to focus solely on serving its clients without external pressures from shareholders or private equity firms. The company's commitment to comprehensive support was evident in its approach to medical coding and identifying questionable claims. With a team of medical doctors and coding experts, Lockton goes beyond traditional insurance brokers, acting as trusted advisors to business owners and CFOs.

The People Solutions Approach

Lockton's people solutions approach sets it apart from other insurance brokers. Rather than simply offering cost-saving solutions, Lockton aims to be a trusted advisor to its clients. By addressing not only healthcare concerns but also broader business challenges such as retention, compensation, and leadership development, Lockton positions itself as a strategic partner in the growth and success of its clients' businesses.

Tradeoffs and Challenges

While transitioning to a civilian career in insurance consulting can be rewarding, it is not without its challenges. Spencer Smith, the podcast host, highlighted the need for consultants to be proficient in their subject matter. The complexity of the healthcare industry requires consultants to continuously update their knowledge and skills to provide the best solutions for their clients. Additionally, veterans transitioning to civilian life may face the challenge of translating their military experience into relevant skills for the insurance consulting field. However, with the right support and networking opportunities, these challenges can be overcome.

In conclusion, veterans transitioning to civilian careers in insurance consulting have a unique set of skills and experiences that can be valuable in this field. By leveraging networking opportunities, seeking support from veteran communities, and aligning with companies like Lockton that prioritize client interests and comprehensive support, veterans can find fulfilling careers in insurance consulting.

In this episode of the podcast @SelfFunded with Spencer, hosted by Spencer Smith and featuring Paul Pruitt, the topic of addressing high medication costs in healthcare was discussed. The episode shed light on the challenges faced by individuals and employers due to the financial burden of expensive medications and explored potential solutions to alleviate this issue.

Paul Pruitt, CGO of SHARx, shared his personal experience of spending $1.8M on annually on medication for his family. This staggering amount highlights the significant impact that high medication costs can have on individuals and their loved ones. SHARx aims to address this problem by offering a medication procurement optimization platform that simplifies the process of accessing expensive medications not covered by traditional health insurance.

One of the key factors discussed in the episode is the importance of personalized healthcare. Pharmacogenomics, which involves studying how an individual's genetic makeup affects their response to medications, was highlighted as a potential solution. By understanding a patient's genetic profile, healthcare providers can optimize their treatment plans and avoid prescribing medications that may have negative effects or provide no benefit. This personalized approach can lead to better health outcomes and potentially reduce medication costs.

However, implementing pharmacogenomics in healthcare comes with its own set of challenges. The episode emphasized the need for an appetite for this approach and ensuring that it doesn't compete against other priorities in the healthcare industry. Balancing the adoption of new tech and approaches with existing practices and systems is a tradeoff that needs to be considered.

Another aspect discussed in the episode is the role of patient assistance programs (PAPs) in helping uninsured or underinsured individuals access free or discounted medications. PAPs provide financial assistance to eligible patients, making medications more affordable and accessible. Exploring alternative sources for medications, such as sourcing from countries like Canada where prices are more affordable, was also mentioned as a potential solution.

The episode highlighted the challenges faced by employers in providing affordable healthcare benefits to their employees. The high cost of medication is a pressing issue that affects both employers and employees. Solutions like those offered by SHARx aim to alleviate this burden by providing medications at zero out-of-pocket cost and offering a more sustainable approach to healthcare coverage.

The current healthcare system in the United States was also discussed as a contributing factor to high medication costs. The supply chain from manufacturers to wholesalers, pharmacies, and patients is often manipulated and broken, leading to inflated prices. The pay-to-play mentality and rebates between different players in the supply chain further complicate the issue. Patients rarely benefit from these rebates, and the cost savings are not passed on to them.

In conclusion, addressing high medication costs in healthcare requires a multi-faceted approach. Personalized healthcare through pharmacogenomics, patient assistance programs, and exploring alternative medication sources are potential solutions. However, implementing these solutions comes with challenges and tradeoffs.

Chapters: 00:01:23 The Potential of Pharmacogenomics in Healthcare 00:08:07 The Financial Strain of High Medication Expenses 00:10:04 Healthcare Solutions for Expensive Medications 00:18:23 Understanding Individual Healthcare Experiences 00:20:50 A Convenient Alternative for Affordable Medication 00:27:03 Accessing Free or Discounted Medications through PAPs 00:33:13 Affordable Medication Sourcing from Abroad 00:43:29 The Delicate Balance of Medication Cost 00:51:00 Timing and Players in Solution Deployment

Executive Medical Benefits with ArmadaCare - Rachel Rutherford

This week's episode features Rachel Rutherford, Sales Director at ArmadCare, where she and host of @SelfFunded with Spencer - Spencer Smith, dive into the world of Executive Benefits.

In today's competitive job market, attracting and retaining top talent is crucial for the success of any organization. Human Resources (HR) directors play a vital role in determining organizational benefits and tailoring them to individual needs. This episode explores the importance of HR in tailoring benefits and attracting top talent.

One key concept highlighted in the episode is the "Zone of Genius." This refers to the intersection of an individual's natural skills and true passions, which leads to career fulfillment and success. By tailoring benefits to cater to the unique needs and aspirations of employees, HR can create an environment where individuals can thrive in their respective zones of genius.

Enhanced benefits, such as ArmadaCare, a supplemental medical reimbursement plan, are discussed as a way to attract and retain top talent. ArmadaCare offers tax advantages, full insurance coverage, and compliance with the Affordable Care Act. While these enhanced benefits may raise questions of fairness to some, they are seen as a valuable tool for caring for key employees and ensuring their well-being.

Rachel Rutherford emphasizes the importance of considering the impact on both the employer and the employees when making decisions about tailoring benefits. She highlights the significant cost of losing key talent and the subsequent expenses associated with replacing them. Retention tools, such as enhanced benefit packages, can save companies hundreds of thousands of dollars in lost productivity and knowledge.

One interesting approach mentioned in the episode is the idea of incentivizing longevity with the employer. By offering different levels of benefits based on years of service, HR can encourage employees to stay with the company. This approach aligns with the goal of attracting and retaining top talent while also considering the financial implications for the organization.

However, there are tradeoffs involved in balancing different factors when tailoring benefits. Rachel acknowledges that increasing benefit packages for recruitment and retention purposes can become expensive, especially when offering them to all employees. HR professionals need to understand the underlying needs and motivations of employers when they request richer plans or retention strategies. It is essential to learn the question behind the question and provide tailored solutions that meet the specific needs of the organization.

In conclusion, the role of HR in tailoring benefits and attracting top talent is crucial for the success of organizations. By understanding the unique needs and aspirations of employees, HR professionals can create benefit packages that align with individual goals and foster career fulfillment. However, there are tradeoffs and challenges involved in balancing different factors, such as cost and fairness. HR professionals must consider the impact on both the employer and the employees when making decisions about benefits. Ultimately, by tailoring benefits and considering the evolving landscape of healthcare, organizations can attract and retain top talent, driving their success in the long run.

Tune into the full episode now!

Chapters:

00:02:46 Tailoring Benefits to Individual Employee Needs 00:08:38 Finding Fulfillment Through Skills and Passions 00:14:35 The Impact of ArmadaCare on Employee Loyalty 00:16:33 Supplemental Medical Reimbursement Plan for Employees 00:24:51 Tax Advantages for ArmadaCare 00:26:42 Executive Medical Benefits 00:31:58 Factors Considered in ArmadaCare Underwriting 00:42:22 The Crossroads of Healthcare's Uncertain Future

Today, we're diving into the world of affordable and accessible healthcare benefits for hourly employees. Meet Hooray Health, a game-changer in the industry that aims to bridge the gap between basic healthcare needs and major medical insurance. With their innovative approach and data-driven insights, Hooray Health is revolutionizing the way we think about healthcare. So, let's jump right in and explore their journey!

The Birth of a Vision:

Shane Foss, the CEO and founder of Hooray Health. They recognized the lack of transparency and affordability in urgent care services and saw an opportunity to make a difference. Inspired by the success of their urgent care model and its similarities to direct primary care, they decided to create a bundled or flat rate system for urgent care visits.

Overcoming Challenges and Building a Network:

To make his vision a reality, Shane gathered urgent care doctors for a roundtable discussion. By identifying common issues and pain points, they developed a contract that was met with enthusiasm by the doctors. This contract offered a $25 copay with no balance bill, eliminating the dreaded surprise medical bills that plague so many.

Building a network of providers in major metro areas was no easy task, but Hooray Health persevered. Within six months, they established contracts with over 50% of urgent cares in the United States, covering 85% of the population within 10 miles of a contracted provider. Talk about accessibility!

Scaling Up and Success:

After their initial success, Hooray Health expanded nationally within two years. Today, they boast a high retention rate and have not lost a client in four years. Siemens Energy, a client for five years, is a testament to the trust and satisfaction their services provide.

Understanding the Limitations:

It's important to note that Hooray Health is not major medical insurance. Instead, it serves as a valuable alternative for those who don't have insurance or need additional coverage. While they cover basic healthcare needs, they do have limitations for catastrophic events. However, they can sit underneath a subsidy on the exchange for individuals who weren't offered an employer-sponsored health plan.

Innovation and Collaboration for a Better Future:

Hooray Health's success story goes beyond providing affordable and accessible healthcare benefits. Spencer and Shane emphasize the need for improved access, transparency, and collaboration between the government and the industry. They believe that by working together, we can address the current issues plaguing the healthcare system and pave the way for a brighter future.

Conclusion:

Hooray Health's journey is a testament to the power of innovation and collaboration in the healthcare industry. By focusing on affordability, accessibility, and meaningful benefits, they are filling the gap for hourly employees who deserve quality healthcare without breaking the bank. With their mobile app, provider network, and commitment to doing the right thing for their members, Hooray Health is paving the way for a future where healthcare is truly accessible to all.

So, let's raise a cheer for Hooray Health and their mission to revolutionize healthcare! Together, we can build a system that prioritizes the well-being of every individual, regardless of their employment status or income level.

Here's to a healthier and happier future for all!

Chapters:

00:00:00 Hooray Health: Affordable and Accessible Healthcare

00:05:39 Opportunity in Urgent Care

00:11:55 Scaling a Direct Primary Care Model

00:18:07 Success in Implementation and Client Management

00:24:53 High Deductible Pregnancy Coverage

00:31:04 Affordable Alternative to Major Medical Insurance

00:37:22 Expanding Access to Affordable Healthcare

00:44:00 The Future of Healthcare

From Tragedy to Triumph: The Journey of Writing 'Wounds'

In this week's episode of the podcast "Self Funded" with Spencer, hosted by Spencer Smith, performance coach Ryan Miller shares his unique coaching approach that combines psychology, self-perception, and personal branding. Ryan's coaching journey began with a focus on sales, but it quickly evolved to encompass a deeper understanding of human behavior and the importance of self-perception in achieving success. Ryan believes that influence, relationship building, and understanding oneself are crucial for success. His coaching aims to help individuals uncover their potential and overcome self-destructive behaviors. He emphasizes the importance of personal branding and authenticity in achieving both professional and personal fulfillment. One of the key aspects of his coaching approach is his focus on psychology and human behavior. He believes that understanding how individuals see themselves and their true potential is essential for unlocking their success. Ryan states, "My coaching today is about seeing inside of other people what they can't see inside of themselves, bringing those things to the surface, and then helping them leverage those tools to go get whatever they want." This coaching approach goes beyond traditional sales techniques and methodologies. While he acknowledges the importance of process and execution, he believes that human behavior and self-perception are the driving forces behind success. He explains, "Sales is a fraction of a percent of what I do to help people be successful as it relates to generating revenue or achieving a goal. Human behavior and psychology, rooted in how we see ourselves and who we really are, is what drives us to be able to execute, to achieve, to be successful." In his upcoming memoir, 'Wounds', Miller shares his personal experiences and challenges, including surviving the Vegas mass shooting in 2017. He believes that healing past wounds and understanding one's own story is crucial for personal growth and success. He says, "I had all these unhealed wounds in my life... all of these were just compounding on top of each other, and they were creating a version of me that I didn't love." Personal branding is another important aspect of Miller's coaching approach. He emphasizes the importance of authenticity and self-discovery in building a unique personal brand. He explains, "There is no worse position in life to be than living as somebody other than yourself." He believes that understanding one's true identity and communicating it effectively is essential for standing out in a competitive market. However, Miller acknowledges that balancing different factors in coaching can be challenging. He states, "But what does that do? That hinders your ability to uniquely identify yourself in a market. And so therefore, the customers that you're trying to pursue don't see you as any different than anybody else." In conclusion, Ryan Miller's coaching approach combines psychology, self-perception, and personal branding to help individuals uncover their potential and achieve success. By understanding human behavior, healing past wounds, and embracing authenticity, he believes that individuals can overcome self-destructive behaviors and achieve both professional and personal fulfillment. Links: Buy Wounds - https://woundsbook.com/ Ryan's Website - https://ryanjamesmiller.com/ Ryan's LinkedIn - https://www.linkedin.com/in/rjmsalespro/ Spencer's Linked - https://www.linkedin.com/in/spencer-smith-self-funded/ Timestamps: (00:01:52) Unleashing Potential Through Coaching (00:04:15) The Power of Books in Personal Growth (00:07:13) Uncovering the driving forces behind success (00:11:06) Transformative journey of writing a memoir (00:16:27) The Journey of 'Wounds': From Tragedy to Triumph (00:19:10) From Vegas Shooting Survivor to Personal Branding

(00:32:49) Embracing Authenticity for Personal Branding Success

In this week's episode, Spencer Smith and Sean Turner delve into Sean's inspiring journey of establishing his insurance agency, Buffer Insurance. We explore the key takeaways from their conversation, offering practical advice and data-driven insights for aspiring entrepreneurs.

Key Highlights:

1. The Challenges of Hiring Employees and Empowering Your Team:

Starting an agency often means taking on the responsibility of hiring employees before revenue catches up. Sean Turner initially faced this challenge but realized the importance of empowering his team. By letting go of responsibilities and investing in employees, Sean witnessed the growth and independence of Buffer Insurance. This highlights the significance of building a business that is not solely dependent on its founder, fostering a culture of trust and support.

2. Partnering for Success: The Power of Collaboration and Independence:

Spencer Smith shares his success story of partnering with vendors and relying on general agencies for guidance. Despite the aggregation and consolidation happening in the insurance market, becoming an independent agent is still possible, especially in areas with new business opportunities like Texas. By staying independent and embracing the concept of the flywheel, entrepreneurs can maintain momentum and attract larger clients.

3. Investing in Employees and Efficient Training Methods:

Onboarding new employees and ensuring efficient training methods are crucial for the growth and success of any business. Spencer attributes his ability to quickly train employees to his military training, where repetition and simplicity were key. By operationalizing processes and investing in employees' development, entrepreneurs can create a healthy culture within their agency and scale effectively.

4. Taking a Controversial Stance: The Power of Values-Based Economy:

Spencer and Sean discuss the impact of their pro-life policies, including paying for birth costs, implementing maternity and paternity leave, and covering adoption expenses. Despite the initial lack of response, the purpose of their announcement was to showcase the possibilities for other employers rather than taking a political stance. This highlights the importance of knowing and standing up for one's values, participating in a values-based economy, and inspiring other businesses to follow suit.

5. Navigating the Changing Landscape of Healthcare

The conversation also touches upon the future of healthcare and the shift from fully insured products to level funded products. Fully insured rates are becoming more expensive due to only sick people remaining in those plans. Sean and Spencer advocate for self-funding as a way to lower costs and enrich benefits simultaneously. These insights shed light on the need for businesses to adapt to the evolving healthcare landscape and explore alternative options for their employees' well-being.

Conclusion:

Sean Turner's journey of starting Buffer Insurance offers valuable insights for aspiring entrepreneurs. From hiring challenges to empowering employees, taking a stand on controversial issues, and adapting to the changing landscape of healthcare, Sean's story is filled with practical advice and data-driven insights.

Enjoy!

Timestamps:

00:00:00) Starting an Insurance Agency

(00:05:30) Transition from Military to Insurance

(00:11:01) Transitioning from Military to Civilian Life

(00:16:30) Letting Go of Responsibilities

(00:21:47) The Growth and Independence of an Insurance Agency

(00:27:29) Viral Moment: Pro-Life Strategies Guide

(00:32:57) Unexpected Viral Success

(00:38:37) Impact of Controversial Stance

(00:44:17) Promoting Stewardship of Health

(00:49:55) The Future of Healthcare

Welcome back to another episode of our podcast, where we dive deep into the world of insurance and healthcare. Today, we have a fascinating conversation between Spencer Smith and Elizabeth Vire, Vice President of National Sales at HPI (Health Plans, Inc.). They discuss the importance of a long-term strategy when working with third-party administrators (TPAs) in the insurance industry, along with practical insights and data-driven advice. So, let's jump right in!

The Power of Strategy and Exceptional Service:

Elizabeth Vire emphasizes the significance of vetting TPAs based on their ownership and long-term solution or exit strategy. She stresses that TPA is not a one-year sell, but rather requires a three to five-year strategy. By asking the right questions about ownership and long-term plans, employers can ensure they are partnering with a TPA that aligns with their goals and values.

Navigating the Healthcare System: Challenges and Hope for Change:

During the conversation, the challenges of navigating the healthcare system are also explored. Elizabeth shares her personal experience of waiting weeks to see a primary care physician and facing delays in referrals to specialists. This struggle resonates with many individuals, even those who are relatively healthy.

However, Elizabeth and Spencer are optimistic about the potential for positive change in the healthcare system. They believe that the private sector has evolved and is paving the way for improvements. They express hope for approaches like direct primary care that prioritize actual care and emphasize the need for change to happen gradually over a few years.

Practical Advice for Employers and Consultants:

Throughout the conversation, Spencer and Elizabeth offer practical advice for employers and consultants in the insurance industry. Here are some key takeaways:

1. Vetting TPAs: When considering a TPA, inquire about their ownership and long-term plans. This will help ensure a strategic fit and a lasting partnership.

2. Understanding Intent: It is crucial to understand the intent of the client's plan and effectively communicate the messaging to employees. This clarity aligns everyone towards the same goals.

3. Full Integration: Invest in partners who offer full integration rather than settling for half-decent solutions. This ensures a seamless experience and maximizes the benefits of the partnership.

4. Data-Driven Decision Making: Before recommending cost containment solutions, gather and analyze data and utilization patterns. This approach allows for informed decisions that yield the best results.

5. The Value of Continuous Learning: Both Spencer and Elizabeth emphasize the importance of continuous learning and professional development. Staying updated with industry trends and insights is vital for success in the ever-changing insurance landscape.

Conclusion:

In this engaging podcast episode, Spencer Smith and Elizabeth Vire shed light on the importance of a long-term strategy when working with TPAs in the insurance industry. By vetting TPAs based on ownership and long-term plans, providing exceptional service, and navigating the challenges of the healthcare system, employers can ensure success in their insurance endeavors

Stay tuned for our next episode, where we explore the innovative solutions offered by Pareto Health, a leading player in the healthcare industry!

Time Stamps:

(00:00:00) Transition from College to Banking

(00:05:48) Career Path in Banking

(00:11:28) Skydiving Mishap

(00:16:53) Transition to HBI: An Independent TPA with a Unique Approach

(00:22:28) Refreshing and Expanding: Rebranding and National Growth

(00:27:56) Opportunities for Dual Option Networks

(00:33:40) Importance of Understanding Client Intent

(00:38:48) Ideal Consultant Partner

(00:44:08) Challenges in Navigating Healthcare

The History of Self-Funding - Larry Turell

Have you ever wondered how self funding in the insurance industry evolved over the years? Wonder no more because that is the theme of this episode of the Self-Funded with Spencer podcast.

In our latest episode, host Spencer Smith and Larry Turrell dive into the fascinating history of self funding, from its humble beginnings to the innovative strategies used today.

Discover how Larry's father helped pioneer one of the very first self funded plan for small to medium sized businesses, and how he passed on that expertise to his son, albeit with apparently some colorful disagreements along the way.

Long before the world of benefits consulting, Larry was a bat boy for the New York Yankees. Larry actually met George Steinbrenner on an airplane at 17, and after making conversation with him, George asked if he would like to work concessions at Yankee Stadium. Larry brazenly said "no, but I would like to be a batboy"!

And not only did he end up getting to perform that job as a teenager for a whopping $29/game at the time, he was also on field during the infamous "Pine Tar" game with George Brett. Larry hilariously recounts the story on the podcast, and it is definitely one to not miss!

In this episode, Larry also opens up about his transition from working with his father to becoming an expert in his craft. He shares how he learned to always aim to "be better than the next guy", constantly expanding his knowledge and expertise.

But what sets Larry apart is his dedication to understanding the intricacies of self-funding and his commitment to providing the best solutions for his clients.

If you're curious to learn more about Larry's journey and gain insights into the world of employee benefits and consulting, this episode is a must-listen!

Don't miss out on this opportunity to hear from one of the best in the industry. Tune in to Self Funded with Spencer podcast now! 🎙️!

Timestamps:

(00:00:00) Adapting to Change in the Insurance Industry

(00:05:41) History of Self-Funding

(00:11:49) Bat Boy for the New York Yankees

(00:17:57) Expertise in Self-Funding

(00:24:03) The Power of Creativity in Problem Solving

(00:30:07) The Benefits of Self-Funding in Insurance

(00:35:35) Misconceptions about self-insurance

(00:41:30) Evolution of Self-Funding

(00:47:28) Evolution of Healthcare Processing

(00:54:02) The Benefits of Self-Funding

Links:

Larry Turell LinkedIn - https://www.linkedin.com/in/laurence-turell-51634751/

Spencer Smith LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Self-Funded YouTube Channel - https://www.youtube.com/c/SpencerSmithSelfFunded

#SelfFunding #InsuranceIndustry #PodcastEpisode #Innovation #HistoryOfInsurance #MustListen

A Better Barber Shop - The Gents Place - Founder - Ben Davis

🎧 Discover the fascinating journey of Ben Davis, founder of Gents Place, in the latest episode of Self Funded with Spencer! 🎙️

From starting his business during the 2008 financial crisis to navigating the insurance world, Ben's story is a rollercoaster of entrepreneurship and resilience. Tune in to hear how he turned a men's hair salon into a country club meets Speakeasy meets barber shop experience.

Ben describes the model of The Gents Place as "Country club meets speakeasy meets barbershop", which blends sophistication, a coolness factor, and networking into a single location for the modern man to get a great haircut and other men's grooming services.

Ben actually started The Gents Place at the young age of 25, using an SBA loan two weeks before The Lehman Brothers collapse, bringing much of the financial and real estate markets with it.

Interestingly, Ben actually started his professional career at Goosehead Insurance, where actually was accompanied by another past guest of the podcast - Lee Lewis. At the time of its inception, Goosehead disrupted the brick and mortar model of personal lines insurance, turning the solution into a 100% virtual experience for it's customers.

Ben left Goosehead to create the vision he had in mind for Gents Place in 2008, without any personal experience in hair or barbershops. He first considered buying an existing franchise, but found those models lacking for what he envisioned. So, rather than going down that road, he decide to create the salon from scratch.

Using his success as a key executive with Goosehead, and connections he had in the banking industry through his time there, he was able to pitch this idea and receive funding for it in very short order, partially because pre-crash, it was a lot easier to get a loan from a bank than it is today.

Ben also has soft-spot for American Veterans, creating a few non-profit organizations dedicated to helping our soldiers. One in particular - Operation Gentlemen® - ties into the Gents Place, where every September they collect gently used suits and work attire at his salons on behalf of Veterans, and then distribute them free of charge at Fort Hood to members of our Armed Services transitioning into the civilian workforce.

Ben is also launching a podcast called "The Untrapped Entrepreneur".

The Podcast helps business owners who are feeling trapped in their businesses and want to unlock the secrets to more freedom and success? In the podcast, Ben dives deep into the strategies and stories of entrepreneurs who have broken free from the grind and found true fulfillment.

💼 In each episode, he interviews real people who have discovered the hacks to untrap themselves from the never-ending work cycle. From escaping 80-hour workweeks to saving marriages, these entrepreneurs have experienced it all. But here's the catch: untrapping yourself is an ongoing journey. The podcast shares people's experiences and lessons learned, so that you can avoid falling into new traps along the way.

Timestamps:

(00:00:00) Entrepreneur's journey in insurance industry

(00:05:40) Genesis of Goosehead Insurance

(00:11:03) Starting a Men's Grooming Business

(00:16:51) Evolution of the Gents Place

(00:22:32) Operation Gentlemen: Helping Homeless Veterans

(00:28:15) Supporting Veterans and US Manufacturing

(00:34:23) Entrepreneurship and Diverse Ventures

(00:40:23) Embracing Change and Risk

(00:46:15) The Importance of Teamwork

(00:52:05) Untrapped Entrepreneurship

(00:57:36) The Importance of Being Open to Learning

#entrepreneurship #businessjourney #insuranceindustry #groomingbusiness

#veteransupport #USmanufacturing #diverseventures #embracingchange

#teamwork #untrappedentrepreneurship

Independent Benefits Consulting with Chris Wolpert of GBS In this podcast episode, Spencer Smith and Chris Wolpert discuss their careers, entrepreneurship, healthcare consulting, marketing strategies, and personal connections. They delve into Chris Wolpert's transition from journalism to the insurance industry, highlighting his focus on work-life balance and employee well-being as an insurance consultant. Chris shares his motivations for starting Group Benefit Solutions and his passion for the group benefits industry, the importance of consulting in modernizing healthcare, eliminating out-of-pocket expenses, and utilizing technology and personalized care is emphasized. He also created a comic books as a marketing tool, showcasing his creativity and ability to connect with prospects. The power of simple content and social connections in building a following on social media is also discussed. Chris has become well-known on LinkedIn because of his recurring theme of sharing Dad Jokes, as well as famous fables that teach life lessons. Overall, the conversations cover a wide range of topics that highlight the importance of balance, creativity, specialization, and personal connections in various professional endeavors. Timestamps: (00:00:00) Chris Wolpert's Career Journey (00:05:37) Starting GBS and Early Challenges (00:11:25) Consulting in Modernizing Healthcare (00:16:53) Using a Comic Book to Differentiate in the Insurance Industry (00:22:58) Comic book storytelling (00:28:38) Specializing in Modernizing Healthcare (00:34:35) The Power of Specialization (00:40:37) The Power of Simple Content (00:45:49) Anticipation of Hanging Out Links: Self Funded on YouTube: https://www.youtube.com/c/SpencerSmithSelfFunded/videos?app=desktop Self Funded With Spencer (Audio Version): https://podcasters.spotify.com/pod/show/spencer-harlan-smith Spencer Smith on LinkedIn: https://www.linkedin.com/in/spencer-smith-self-funded/ GBS Website: https://gbsbenefitsgroup.com/ Chris Wolpert on LinkedIn: https://www.linkedin.com/in/chris-wolpert/ #careerjourney #entrepreneur #healthcareconsulting #insuranceindustry #marketingstrategies #worklifebalance #specialization #contentmarketing #socialconnections #personaldevelopment

PBM Consulting - Bringing Transparency to Pharmacy with Trevor Daer of Granite Peak Analytics Trevor Daer, the founder of Granite Peak Analytics, joins me on the orange couch to explore the world of pharmacy analytics and the importance of data in making informed PBM decisions. This episode of the Self-Funded with Spencer Podcast explores the world of pharmacy rebates and the importance of collaboration in making progress and saving money. Spencer Smith and Trevor Daer discuss the PBM space and how Granite Peak Analytics can help large payers make educated decisions. Additionally, PBM Consulting Solutions provide employers with objective analysis and guidance to help them save on prescription drug costs. Furthermore, the episode touches on the growing concern of specialty pharmacy risk as well as how to scale impact and make a difference in the world. Through dialogue about the importance of communication and understanding the "why" behind processes, this episode emphasizes how collaboration is key to achieving successful outcomes. Quotes: 1. On Life in Montana - "People are people regardless of where they're from. So I think that's one thing why people keep moving there is we're pretty welcoming." 2. On why Consultants use Granite Peak - "Rather than having to try to find 17 different vendors based on a situation you're offering, hey, I will give your entire book of business a single contract for them to make sense of." 3. So I think if every kind of component of this infinitely complex system really honed in on their area and said, no, we're going to be more accountable and we're going to kind of align incentives, I think we could really move forward as a better well, I would.

Links:

Trevor LinkedIn Profile - https://www.linkedin.com/in/trevor-daer-22455b30/

Granite Peak Analytics LinkedIn - https://www.linkedin.com/company/granite-peak-analytics-llc/

Granite Peak Analytics Website - https://granitepeakrx.com/

Spencer LinkedIn Profile - https://www.linkedin.com/in/spencer-smith-self-funded/

Self-Funded with Spencer on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=89a1b922dcf84da0

Self-Funded with Spencer on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Self-Funded with Spencer YouTube Channel - https://www.youtube.com/@SelfFunded Timestamps: (00:00:00) Montana Life (00:05:38) Pharmacy Consulting Career (00:11:03)Exploring PBM Space (00:16:30) Pharmacy Rebates (00:22:25) Creating Granite Peak (00:28:14) Granite Peak Analytics (00:33:59) PBM Consulting Solutions (00:39:27) Specialty Pharmacy Risk (00:45:07) Scaling Impact #entrepreneurship #pharmacy #PBM #rebates #GranitePeak #analytics#solutions #specialtypharmacy #risk #scalingimpact

Unlocking Cost Savings with Reference Based Pricing (RBP) - ClaimDOC - Omar Arif

This week I sit down with Omar Arif, SVP of Growth with ClaimDoc to answer the question, "What is Reference Based Pricing, aka "RBP"?"

Omar Arif, the SVP of Growth for Claim Doc, a cost containment vendor, was sold on RBP when he discovered it. Claim Doc provides a balanced approach to RBP, combining both "pay and defend" and "negotiate and settle strategies".

Omar states that their network replacement is the most buttoned up in the industry, with all legal work, provider relations, and member services done in-house. The give and take of pay and defend vs. negotiate and settle is up to the individual to decide.

Claim Doc's clinical team of nurses and coding experts performs a clinical audit on every single bill before re-pricing the claim. They also cap themselves out per claim to avoid being egregious and to be more friendly to stop loss markets.

Stop loss carriers that have taken the time to learn ClaimDoc's model and have experience with them will often offer lower stop loss rates. Claim Doc is also transparent about how they get paid, taking a percentage of the build charge.

Claim Doc is a family owned boutique company that is not the norm in the healthcare reimbursement space, which is mostly private equity or venture capital backed firms. They have 120 employees, with half of them being member facing to ensure access to care outside of a traditional contract and handle any billing questions.

Why are so many people switching to ClaimDoc?

It is because they say "They're working to make your self-funded insurance plan remarkable. Using next-generation technology paired with a human touch, they deliver transparent medical claim pricing and allow our clients' health plans to thrive."

Links:

Self Funded on YouTube: https://www.youtube.com/c/SpencerSmithSelfFunded/videos?app=desktop

Self Funded With Spencer (Audio Version): https://podcasters.spotify.com/pod/show/spencer-harlan-smith

ClaimDoc Website - https://claim-doc.com/

ClaimDoc LinkedIn Page - https://www.linkedin.com/company/claimdoc/

Omar Arif LinkedIn Page - https://www.linkedin.com/in/omararif1/

Timestamps:

5:00 - Lamborghini Dreams

7:45 - Playing Pro Baseball

14:56 - Getting Hooked On Sales

21:30 - What Is An RBP?

35:23 - RBP Implementation

41:11- Employer Communication

47:41 - Medicare As A Reference Point

54:10 - Will RBP Ever Become The Norm?

59:06 - Conclusion

#entrepreneurship #LamborghiniDreams #ProBaseball #ContrarianSelling #ReferenceBasedPricing #RBPNetworkReplacement #RBPImplementation #MedicareReimbursementRates #RBPBenefits #TheEntrepreneursJournal

Episode 100! - The Benefits Roundtable with Seth Denson, Dennis Fowler & Chris Hamilton

Self-Funded with Spencer is excited to release the 100th episode of the podcast!

For this episode, we set out to deliver a truly unique experience, with 3 guests, 5 cameras, and 90 minutes of insights from the brightest minds in employee benefits!

With a wide variety of opinions from their extensive experience in insurance and benefits companies, Spencer, Dennis, Scott and Chris explore major trends in the industry like vertical integration into the provider space, understanding workplace spending habits, and navigating the employee lifecycle in a more efficient manner.

From this, they form a discussion on how to unbundle and re-bundle products seamlessly and provide doctor access through direct primary virtual care. The guests offer insight on being an agent vs consultant, finding a mentor, financial literacy in the population, and preparing a new generation for the future. They explain that companies are competing for talent and need to educate employees through financial literacy as well as insights from a mentor.

Last, they discuss the need to make healthcare efficient and create a scale of a prudent buyer, the benefits of a self-insuring plan and its application, and the importance of taking time to celebrate milestones.

Join Spencer and his guests for an engaging and informative episode about the benefits industry and its changes.

Topics with Timestamps:

[00:00:0] Intro

[00:03:50] Emergence of Three Trends in the Benefits Industry

[00:07:03] Managing the Employee Lifecycle in a Post-Pandemic Workplace

[00:09:40] Unbundling and Re-Bundling Healthcare

[00:12:30] Making Accessible Health Care for People in Unique Occupations.

[00:15:55] The Need to Restructure the Healthcare System

[00:18:34] The Benefits of Human Connections in Decision-Making

[00:21:09] Generational Shift in Training

[00:24:07] Establishing a Foundation for Educational Success

[00:27:56] Competing for Talent: Education and Financial Literacy

[00:30:50] The Benefits of Consulting vs Selling Insurance

[00:35:32] The Role of Fee-Based Advisory Firms in the Future

[00:39:08] Navigating the On and Off Ramps of the Superhighway

[00:44:29] Being the Expert vs Bringing In an Expert

[00:48:00] Finding a Mentor for Success

[00:53:08] Audience Questions - Best Client Case Study

[00:57:15] Most Rewarding Client Story

[0059:14] How to Address Change in the Small Group Market

[01:06:55] What Was your First Car?

[01:12:45] Celebrate a Milestone on The Podcast

[01:14:25] The Power of Education

[01:16:30] The Origin Story of The Self-Funded with Spencer Podcast

[01:17:45] Enjoying The Process vs Outcome Obsession

[01:19:30] Building Broad Knowledge with Content

[01:21:03] Learning from Others

[01:24:25] The Biggest Surprises from Podcasting

[01:26:00] The Growth of an Entrepreneur

[01:27:45] Joining ParetoHealth

[01:29:50] Closing Thoughts

[01:31:28] Thank You to Nathaniel

This episodes features:

1. Seth Denson, Head of Employee Benefits at @AcrisureOfficial

Company Website - https://www.acrisure.com/

LinkedIn Profile - https://www.linkedin.com/in/sethdenson/

2. Dennis Fowler, Employee Benefits Practice Leader at @baldwinriskpartners8375

https://baldwinriskpartners.com/

LinkedIn Profile - https://www.linkedin.com/in/dennis-fowler-b105a6b/

3. Chris Hamilton, Employee Benefits Practice Leader at @hotchkissinsurance8816

Company Website - https://hotchkissinsurance.com/

LinkedIn Profile - https://www.linkedin.com/in/chamilton/

The Benefits Insider - https://hotchkissinsurance.com/benefitsinsider

he Connective Tissue of a Health Plan - Planned Administrators Inc

In the latest episode of "Self-Funded with Spencer," host Spencer Smith invites George Stiles, the President and COO of Planned Administrators Inc (PAI), to discuss the transformation of the TPA industry and what makes a good TPA partner.

George shares his journey from claims processor at Blue Cross Blue Shield to his current role at PAI.

The conversation covers topics from data analytics, and direct primary care, to how to navigate the new regulations in transparency. Hear about PAI's reliable data center with top-notch security and where over a billion claims run through every year.

Listen in as Spencer and George provide insight and knowledge on the ever-changing healthcare industry. Listeners will also gain insights into data analytics, the trends in the stop-loss market, and the optimism surrounding the future of healthcare

The dynamic conversation also includes discussions on transparency in healthcare pricing, attracting the next generation of superstars in the industry, and the importance of collaboration between TPAs and brokers

Visit their website, paisc.com, to connect and discover inbound activities as a proof of their successful podcast.

You won't want to miss this engaging episode filled with valuable information and expert insights!

[00:00:09] George Styles' Journey to Providing TPA Services

[00:03:12] The Guest's Journey in Healthcare and Public Policy

[00:06:28] Blue Cross Technical Support and Data Center

[00:09:35] The Benefits of Corporate Entrepreneurship and Third-Party Administrators

[00:15:36] Level funding as a stepping stone

[00:18:32] Challenges and Benefits of Direct Primary Care Expansion

[00:21:46] Quality Healthcare and Medical Expenses Correlation

[00:24:48] The Value of Data Analytics in Employee Benefits Management

[00:27:52] Data Analytics in Self-Funded Healthcare Plans

[00:30:56] The Value of a Trusted TPA Partner

[00:33:48] Stop Loss Marketing Shift

[00:40:06] Advantages of healthcare transparency

[00:43:05] Nurturing Young Talent and Industry Innovation

#healthcareindustry #TPAservices #dataanalytics #healthpolicy #selffunding #directprimarycare #employeefinancialhealth #transparency #insuranceindustry #innovation #longtermpartnerships #healthcareconsulting #TPApartnerships #insuranceconsultants #employeebenefits #healthcarereform #entrepreneurmindset #healthcaredata #stoplosscarriers #futureofhealthcare #TPAadvantages #employeehealth #healthcareauditing #employeetransparency #healthcaretechnology #healthcareaccessibility #insurancedata #healthcareanalytics #healthcarequality #medicare #healthcare

Health Payment Accounts (HPA) with Paytient CEO - Brian Whorley

Welcome to Self-Funded with Spencer, where we dive into the world of healthcare and explore ways to make healthcare coverage more accessible and effortless for everyone.

In this episode, Spencer Smith welcomes Brian Whorley, CEO and founder of Paytient. Brian is creating a new category for health payment accounts that helps remove the impediment of out-of-pocket costs for patients. Together they discuss the importance of creating a feeling of security, peace of mind, and confidence in the form of a Visa card for health plan members.

Throughout the podcast, Spencer and Brian cover a range of topics, from the importance of empathy and considering patient needs to the impact of removing barriers to healthcare consumption.

They delve into Paytient's product experience that allows employers to offer medical, dental, vision, pharmacy, and veterinary expense repayment options to employees, enabling them to make tax-advantaged payments for eligible transactions.

In this episode, you'll also hear about Brian's previous venture, "Big Tree," and the journey that led to the creation of Paytient. Spencer and Brian discuss the various decisions and policies that shape a patient's healthcare journey, and how Paytient is working to make healthcare accessible and affordable through a frictionless and effortless system.

Get ready to be inspired by a team focused on creating real-world solutions to a real-world problem. Tune in to Self-Funded with Spencer to learn more about how Paytient is making healthcare better for everyone, regardless of their situation.

Timestamps:

[00:00:09] Pareto Health and Paytient's Benefit Solutions

[00:03:13] Guest's Work Experience & Passion in Healthcare Industry

[00:06:55] The Importance of Empathy in Patient Care

[00:10:33] Innovative Food Platform and Entrepreneurial Lessons

[00:13:23] Name badge payments for workplace expenses

[00:16:17] Paying for healthcare challenges and credit card solution

[00:19:52] Introducing Patient: An Innovative Payment Card Solution

[00:23:29] Flexible Employee Benefits Platform

[00:26:55] Equitable Health Plan ROI

[00:30:24] Accessible Healthcare Payments for Better Outcomes

[00:33:35] Improving healthcare accessibility and quality

[00:37:24] Improving Future Healthcare through Innovation

[00:41:11] The Future of Frictionless Healthcare

[00:44:32] The Future of Retirement and Healthcare

[00:47:59] Public Catastrophic Plan for Healthcare

[00:51:34] Working with consultants and brokers in healthcare

Quotes:

"And so that's what motivated me, like, every single day of of how do we serve others?"

" I love building things or creating things and kinda going from 0 to 1...Or trying to make things that exist a little bit better. And so that's kind of core to my DNA, what I enjoy doing."

#employeebenefits #selffunded #healthpaymentaccount #healthcareaccess #healthoutcomes #healthplans #ROI #catastrophicinsurance #healthcareplatform #universalcoverage #healthinsurance #consultants #brokers #affordablehealthcare #podcastinterview

Revolutionizing Healthcare Coordination and Advocacy with Curus

Get ready to dive into the world of healthcare benefits and savings with Spencer Smith's Self-Funded podcast, sponsored by Pareto Health.

In this episode, COO Jared Mort from Curus Health shares his expertise on clinical care coordination, or as he refers to it "Care Orchestration", and how to help mid-sized employers reduce their healthcare costs.

Jared also discusses Curus Health's approach to total life concierge services, which assists people with chronic illness and clinical conditions in navigating the healthcare system.

The conversation is both informative and emotional as Jared and Spencer discuss real-life examples of how Curus Health has helped patients get the necessary care they need while maintaining the quality of their life.

Throughout the podcast, Jared emphasizes the importance of coaching patients and encouraging them to be active participants in their care. He discusses the adverse selection and how Curus Health helps reduce costs while mitigating the risk of expensive medical bills.

The podcast also explores the team's approach to managing end-of-life care for patients and their families, even after the contract has expired.

Jared & Spencer also discuss the challenges of marketing healthcare services to employers and brokers. Jared talks about the cultural apathy that has developed as a result of the bureaucracy and the overwhelming nature of the industry.

The hosts emphasize the immense value their services provide to members and the need for more employers to take advantage of them.

If you're interested in learning more about healthcare benefits and saving money on your healthcare costs, then the Self-Funded podcast with Spencer Smith is for you.

Tune in now to learn more!

Timestamps:

[00:03:27] Career in Air Force and Transition to Civilian World

[00:09:11] Fortnite and Curus: Gaming and Healthcare Mix

[00:12:21] Managing Rising Drug Costs in Healthcare

[00:15:25] Curus: Revolutionizing Medical Treatment and Patient Care

[00:18:30] Virtual healthcare coordination and patient empowerment

[00:21:35] Humanity in healthcare

[00:24:37] Importance of Patient Advocacy in Healthcare

[00:27:45] How medical SWAT teams assist with ongoing medical costs

[00:30:32] Marketing Strategies for a Health Product

[00:33:43] Challenges in Healthcare Sector and Innovative Solutions

[00:36:45] Scalability and Solutions for Healthcare Providers

[00:40:02] Curus Health's support for all businesses

Hashtags

#healthbenefits #employeebenefits #healthcare #selffunding #clinicalcarecoorination #airforceveteran #virtualhealthcare #patientadvocacy #medicalcosts #healthoutcomes #healthcareproviders #malpractice #adverseselect #chroniccare #curishealth #paretohealth #podcasts #healthpodcasts #healthcarepodcasts #smallbusinesshealthcare #healthcarecosts #insurance #healthinsurance #virtualcare #virtualmedicine #patientcare

Data Analytics for the Modern Benefits Broker - Mike Pattengale - Springbuk

Looking to learn about the future of data analytics in healthcare? Look no further than Self-Funded with Spencer!

Host Spencer Smith welcomes guest Mike Pattengale from Springbuk to discuss their innovative approach to data analytics and how it helps drive informed decisions.

The two discuss the impact of COVID-19 on the healthcare industry and how data analytics can help employers make better decisions regarding the well-being of their employees.

Mike and Spencer reflect on their experience of navigating the pandemic and the challenges it brought with it, along with its unexpected benefits, such as exploring new avenues like podcasting.

As they transition to talking about healthcare analytics, Mike, emphasizes the platform's ability to collect and normalize data from various sources, highlighting the collaborative nature of Springbuk's platform. They discuss the value of data analytics, how it can be used to make informed decisions, and the importance of sharing data and embracing technology in the consulting industry.

Mike also discusses the capabilities of their system, including the use of artificial intelligence to identify actionable insights and its clinical and financial impact. They also emphasize the importance of an intentional approach to presenting software features to clients to help them focus on the issues that matter most to them.

Overall, the episode provides a wealth of information about the healthcare industry, data analytics, and empowering employers to better manage their claims cost. The hosts and guest make compelling arguments about the benefits of using analytics, embrace of technology, and the importance of forging lasting relationships.

This is an episode you won't want to miss, and it's a fantastic introduction to the world of healthcare analytics.

Tune in to Self-Funded with Spencer and get ready to learn something new!

Timestamps

[00:00:09] Navigating Zoom during the pandemic

[00:03:19] Mike's Career Pivot during COVID

[00:09:47] Mastering sales skills through storytelling and connecting

[00:19:24] The Downside of Entrepreneurship

[00:22:19] Mike's sales career journey

[00:25:25] The Growth and Innovation of Springbuck

[00:28:21] Integrating Data Sources for Health Plan Management

[00:31:42] Turning Data into Action with Springbuck's Solutions

[00:34:53] Data Analysis in Healthcare Spending

[00:38:14] Post-COVID Tech Sales Advancements

[00:41:27] Benefits and Target Market for the Solution

[00:44:44] Data Analytics for Managing Healthcare Costs

[00:47:39] The Future of Data Analytics in Business

[00:51:00] Balancing Technology and Skilled Professionals in the Industry

[00:53:58] AI and Actionable Insights

[00:57:01] Future of Healthcare Data Analytics

[01:00:07] Challenging Industry Status Quo with Younger Workforce

Best Quotes:

"I realized everything that I was confident in and my ability to sell was winning people over in person. And I took every strength that I thought I had and it was removed..."

"Coming out of the pandemic, and when people go back to real world, you'll either become a hunk, a chunk, or a punk..."

[00:05:52] Obviously, brokers need to be talking about this with their employers nowadays, or you're gonna be in a losing position"

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