Self-Funded With Spencer: Recent Episodes
Spencer Smith
Self-funded with Spencer shares inspiring conversations with the most successful and influential people in healthcare - company founders, CEOs, entrepreneurs, doctors, sales leaders, and more - to help educate and inspire YOU to become the best version of yourself. Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"Eat your food as medicine or medicine will become your food." - Chef Austin Simmons
Can better beef solve America's health crisis? My guests this week, Chef Austin Simmons of Chef and Rancher and benefits/nutrition expert Chris Pierron, believe it's a critical part of the solution. They join the show to discuss the deep connection between cattle genetics, our broken food system, and our exploding healthcare costs.
Chef Austin explains his "hoof to fork" model for creating "better beef." We discuss how using purebred, genetically-verified cattle and clean feeding practices, free of the seed oils and used fryer oil common in the commercial industry, produces a more nutrient-dense and flavorful product.
This isn't just about a better steak; it's about creating a healthier population from the ground up. We explore how fixing the food system is the most important step to lowering healthcare costs, and why consumer education is the key to driving this change.
Tune in today for a conversation that will change the way you think about the beef on your plate.
Chapters:
(00:00:00) How Better Beef Can Solve America's Health Crisis
(00:05:18) The Hidden Additives & "Poisons" in Most Beef
(00:19:38) Why is Prime Beef So Inconsistent?
(00:20:58) The Power of Cattle Genetics
(00:37:47) Is There Used Fryer Oil In Your Steak?
(00:54:22) Should We Federally Subsidize Beef?
(01:02:09) Why Food Education is the First Step
(01:13:26) Fixing the Food System to Fix Healthcare
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"If we can remove the cost barrier, folks are going to engage more because it's not standing in the way of going to get the care that they need or even preventive care." - Trey Smith
High healthcare deductibles were sold to employers as a way to create better "consumers" of healthcare. My guest this week, Trey Smith of Hub International, argues that they've been a failed experiment that has done more harm than good. Instead of creating smarter shoppers, high deductibles have become a massive barrier to care, causing employees to delay or avoid necessary treatment altogether.
In this episode, Trey breaks down the alternative: first dollar coverage.
We discuss how innovative plan designs with zero deductibles can actually lower an employer's overall claim spend over time by encouraging early intervention and proactive care. He shares data showing that while utilization spikes initially, long-term costs come down significantly as members get the care they need when they need it.
This conversation is a perfect example of why the benefits consultant's role is shifting from simply brokering insurance to designing strategic solutions that solve real problems for employees and employers. I hope you'll tune in!
Chapters:
(00:00:00) High Healthcare Deductibles Are A Failed Experiment
(00:26:16) The Risk of Innovation vs. The Risk of the Status Quo
(00:29:59) The Problem: High Deductibles as a Barrier to Care
(00:34:10) The Solution: "First Dollar" Coverage
(00:38:22) Simplifying the Healthcare Experience
(00:52:17) How Data is Making New Plan Designs Possible
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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 can look for something on Amazon and have it shipped to my door tomorrow... so why wouldn't employees want a similar experience with their healthcare?" - Amanda Volner
Can artificial intelligence actually make healthcare feel more human?
Amanda Volner, AVP of Broker Partnerships at Healthee, joins the show for a deep dive into the real role of AI in the benefits industry. We discuss how artificial intelligence is a powerful tool to augment our abilities, but why uniquely human skills like critical thinking, building relationships, and understanding "the question behind the question" are more valuable than ever.
Amanda breaks down how Healthee is using AI to create "hyper-personalized" healthcare experiences for members, from navigating benefits to finding cost-effective pharmacy solutions. We explore how modern engagement platforms are essential for communicating with a decentralized workforce and how AI can be trained to match your own voice and tone.
The conversation also explores the human side of a demanding career, from the challenges of being a single mother in this industry to navigating sobriety in professional settings.
Tune in for a fascinating look at the intersection of AI, healthcare, and what it truly means to be human in our industry.
Chapters:
(00:00:00) Making Healthcare More Human...Using AI
(00:01:09) The One Thing AI Still Can't Do
(00:04:36) Understanding "The Question Behind the Question"
(00:26:02) The Future of "Hyper-Personalized" Healthcare
(00:37:07) Using AI to Lower Prescription Costs
(00:50:12) Balancing a Demanding Career and Family
(01:02:32) Navigating Sobriety in the Benefits World
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"Good entrepreneurs fall in love with their solution and their platform, but great entrepreneurs fall in love with the problem." - Matt Scovil
Matt Scovil and Nathan Gilchrist of Medefy Health, have fallen in love with one of the biggest problems in benefits: nobody wants to engage with them. They joined the show to discuss their journey of building a platform designed to solve the engagement crisis and simplify the healthcare experience for everyone.
Matt and Nathan break down their "bottoms-up" approach to this problem, which focuses on engaging members when they need help through a high-touch, live support model delivered via mobile app. We discuss how they use the psychology of "loss aversion" and constant communication to drive engagement rates over 90%.
We also explore how Medefy acts as the "quarterback" for a health plan, removing friction by navigating members to the right solutions. This is all part of their vision for the future of healthcare, where the experience is "heavily, heavily individualized" for each person.
Chapters:
(00:00:00) Why Employees Would Rather Clean a Toilet Than Use Their Benefits
(00:04:18) Cleaning a Toilet vs. Learning Your Benefits
(00:08:46) Falling in Love with the Problem, Not the Solution
(00:14:23) The Power of Live, Human Support
(00:19:08) Using "Loss Aversion" to Drive Engagement
(00:34:54) The Quarterback for Your Health Plan
(00:47:57) How AI is Augmenting the Human Touch
(01:00:01) The Future of Healthcare is "Individualized"
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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 think the three strongest words that you can use as a leader, as a salesperson, as a client relationship person is I don't know." - Scott Milson
My guest this week, 35-year industry veteran and author Scott Milson, joins the show for a deep dive into the mindset required for a long and successful career. We discuss his journey from a self-described "career B student" to a partner at a major firm, and the lessons he learned about loyalty, hard work, and what it truly means to be excellent.
Scott breaks down his personal playbook for "tuning into the frequency of excellence." He shares his "Be 5 Framework" (Be Present, Curious, Intentional, Bold, and Reflective) and explains why embracing discomfort, adopting a growth mindset, and learning through informal mentorship are crucial for professional growth.
It’s worth noting that Scott is also professionally in the benefits industry, so I wanted to have him on the show to directly speak to those in this space.
I hope you'll tune in for this insightful conversation!
Chapters:
(00:00:00) Tuning Into The Frequency Of Excellence
(00:20:08) Why Discomfort is the Path to Growth
(00:21:56) The 3 Words That Defeat Imposter Syndrome
(00:27:52) The "Success to Significance" Curve
(00:38:42) The “Be 5” Framework for Excellence
(00:40:52) The Myth of Formal Mentorship
(00:48:25) "How You Do Anything is How You Do Everything"
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"We spend about $528 billion a year fixing the mistakes we make with medicines." - Chris Grilli
Fixing healthcare's $528 billion dollar mistake starts with ending the "trial-and-error" prescribing that plagues our system. My guest this week, pharmacist and genomics expert Chris Grilli of RxMapper, joined the show to explain how personalized, DNA-guided medicine is the key to solving this massive problem.
Chris breaks down the RxMapper model, explaining how they analyze 36 million data points from a patient's genome to provide medication recommendations with nearly 90% accuracy. We discuss the crucial difference between genetics and genomics, and how this approach saves thousands of dollars per patient while dramatically improving outcomes.
The mission to fix this problem is also a personal one. Chris shared the story of how his grandmother's preventable death from an adverse drug event became the inspiration for building RxMapper to ensure other families don't suffer the same fate.
Tune in this week for the playbook on fixing one healthcare's most expensive mistakes.
Chapters:
(00:00:00) Fixing Healthcare's $528 Billion Dollar Mistake
(00:02:12) The $528 Billion Cost of Medication Errors
(00:04:43) Genetics vs. Genomics: What's the Difference?
(00:10:29) Are Doctors Prescribing "Poison?"
(00:14:18) The Personal Story Behind RxMapper
(00:27:17) Saving Over $8,600 Per Patient
(00:41:24) How Your DNA Impacts Ozempic's Effectiveness
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"There's a big difference for me in living and being alive. There's a difference between breathing and truly experiencing life." - Todd Whitthorne
My guest this week Todd Whitthorne joined me for a conversation that goes far beyond the balance sheet to explore the true meaning of well-being. We discuss why a leader's personal health is the foundational, non-negotiable asset for their professional success.
Todd breaks down the crucial role leaders play in building trust and creating a "culture of health" that yields a real financial, clinical, and cultural ROI. We explore the five pillars of well-being (fitness, nutrition, sleep, stress, and prevention), the difference between "lifespan" and "healthspan," and why investing in yourself is the least selfish thing a leader can do.
The episode concludes with the incredible true story of Todd's 70-year-old friend who survived being hit and run over by a drunk driver, which is a powerful testament to how a lifelong commitment to fitness creates true resilience. I hope you’ll tune in for this inspirational conversation!
Chapters:
(00:00:00) Lessons in Health & Leadership
(00:06:11) Why Trust is a Leader's Most Important Asset
(00:14:14) The Difference Between Lifespan and Healthspan
(00:17:06) Why Investing in Yourself Isn't Selfish
(00:48:59) The Pursuit of True Happiness
(01:05:49) The 70-Year-Old Who Survived And Thrived After a Hit-and-Run
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"Understanding how an underwriter thinks and how they manage risk allows you to create a solution that actually creates impact and change for the long term." - Bobby Stuart
This week on the show, I'm joined by Bobby Stuart, a benefits consultant with Hotchkiss Insurance, for a deep dive into the mindset of a modern, forward-thinking advisor. We discuss his journey into the industry and what it takes to guide employers through the complexities of self-funding.
Bobby also broke down his playbook for creating long-term value for his clients. We explore why learning to "think like an underwriter" is a crucial skill for managing risk, the importance of simplifying complex ideas for employers, and why mastering the industry's language is the first step to finding simple solutions.
We also discuss how these strategies translate into real-world results, including how Bobby's team uses direct contracts and early intervention to help members get high-cost cancer care for free, removing the financial burden so they can focus on their health.
Chapters:
(00:00:00) How To Think Like An Underwriter (And Why It’s A Game-Changer)
(00:04:03) Overcoming the Complexity of Self-Funding
(00:04:59) Learning to Speak the Language of Insurance
(00:08:49) The Power of Thinking Like an Underwriter
(00:18:48) How To Stay Optimistic As A Benefits Consultant
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"The balance bill came in, it was 37 grand for this member, and we were able to get that thing fully wiped." - Patrick Haig
My guest this week, Patrick Haig, Co-Founder of Goodbill, has built a company designed to find errors in medical bills and fix them. From upcoding to time-based discrepancies, these inaccuracies cost health plans and their members a fortune.
In this episode, Patrick breaks down the Goodbill model. We discuss how their technology integrates directly with health plans to audit claims for errors before they're paid, and why that “upstream” approach is so game-changing. We also dive into one of their most powerful tools: the underutilized 501(r) IRS rule that can wipe out bills entirely, even for six-figure income families.
This episode is personal for me, as Patrick's team fixed my own son's ER bill, saving almost $1,000. I hope you’ll tune in!
Chapters:
(00:10:22) How DPC inspired Goodbill
(00:23:03) The 501(r) Secret: Hospital Financial Assistance
(00:27:15) How Upcoding Inflates Your ER Bill
(00:38:29) The Art of Negotiating a Hospital Bill
(00:48:43) Why "Upstream" Claim Auditing is a Game-Changer
(00:59:29) Can a Six-Figure Family Qualify for Assistance?
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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 doubled my profit when I lost 70% of my customers, which is insane." - Brad Hart
My guest this week, Brad Hart, owner of Forest Park Pharmacy, came on the show to discuss how he moved his pharmacy from struggling to survive in a broken, insurance-based reimbursement model to thriving as an all-cash, "cost-plus" business.
Brad popped on my radar because of his very popular and informative Instagram profile, where he shows how everyday Americans are getting fleeced by PBMs. We break down the mechanics of his model and discuss the "low copay trap," why the term "specialty generic" is nonsense, and how his pharmacy's Price Checker tool brings radical transparency to a purposefully confusing industry.
We also dive into the exponential overpayments Brad has uncovered in the Medicare system, where a drug that costs his pharmacy $96 is reimbursed for over $3,400.
This is one you won't want to miss!
Chapters:
(00:00:00) This Pharmacy Went Cash-Only, Lost 70% Of Customers, & Doubled Profits
(00:07:28) The "Cost-Plus" Pharmacy Model, Explained
(00:08:49) How Brad Lost 70% of Customers & Doubled Profits
(00:10:45) The Deceptive "Low Copay Trap"
(00:13:29) The Pricing Breakdown: Cost + 15% + $10
(00:34:52) Why the Term "Specialty Generic" is Nonsense
(00:47:53) What is the Average Wholesale Price (AWP)?
(00:52:41) PBM Reform vs. Direct-to-Consumer
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"Nomi actually stands for 'no middleman'. Take out that invented complexity... Price comes way down, becomes more simple to administer, and there's plenty of dollars to go around for providers now making more money." - Josh Walker
My guest this week, Josh Walker, Founder & COO of Nomi Health, is on a mission to rebuild healthcare by tackling its "invented complexity." He joined me on the show to explain why creating a direct relationship between the buyers and providers of care is the key to a better, more affordable system for everyone.
How does Nomi do it? We break down their playbook, which focuses on three core strategies: standardizing data formats to improve efficiency, embracing price discovery to find the true cost of care, and simplifying payment dynamics to cut out the middlemen.
This isn't just theory. Joshua shares the powerful, real-world results of their model, including how one client's benefits leader received a standing ovation from employees after switching to a plan that eliminated all financial barriers to care.
Tune in this week to learn why it’s so important to find the true cost of care, and why I’m so proud to have Nomi as a sponsor for the show!
Chapters:
(00:00:44) What Does NOMI Stand For?
(00:11:36) Finding the "True Cost of Care"
(00:23:27) Do We Even Need Networks Anymore?
(00:35:14) What Churros Can Teach Us About Data Analytics
(00:52:19) From Solution Taker to Solution Maker
(00:55:59) The "Standing Ovation" Health Plan
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“Does your consultant understand these kind of strategies and mechanisms are available in the market and do they know how to implement them and make them work?" - Riley DearingRiley Dearing of Hotchkiss Insurance returns to the show this week, and he’s brought with him Blake Allison, CEO of Employers Health Network (EHN) to talk all about high-performance health networks and the massive opportunity they represent.Ever wonder how high-performance health networks actually work? We broke down the real mechanics: how direct provider partnerships are built, how benefit design drives engagement to the right facilities, and how this collaborative approach leads to better data, lower costs, and predictable risk for employers.This isn't just theory; we also announce EHN's new partnership with Covenant Health, detailing how this model is being scaled to bring these powerful solutions to employers across West Texas.Tune in this week for the definitive guide on how high-performance health networks actually work!Chapters:(00:00:00) How the World's #1 Chevy Dealer Saved $3 Million on Healthcare
(00:10:30) Enhancing Healthcare Networks
(00:16:23) Making Sure Members Can Get Care In Their Area
(00:22:30) Empowering Patients
(00:25:43) Navigating Healthcare Pricing Strategy
(00:35:23) Enhancing Healthcare Affordability
(00:47:14) Data-Driven Healthcare
(00:57:17) Zero Out-of-Pocket Cost For MembersKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.This episode covers healthcare news from June to mid-July 2025.And we play a new game called the "Which Has Less Ingredients?", which is exactly like what the title suggests.Chapters: 0:00 - Intro0:22 - A proposal to ban drug ads2:48 - Pre-diabetes rates in children have tripled in 25 years5:25 - Healthcare workers leaking patient data through AI7:06 - Mark Cuban's healthcare plan10:05 - Healthcare is the top employer in most states12:49 - The Self-Funded Review19:37 - Which Has Less Ingredients? (this month's game)27:27- Ask Spencer AnythingSources: https://phys.org/news/2025-06-glass-bottles-microplastics-plastic.htmlhttps://x.com/mcuban/status/1934834421225672999https://www.scrippsnews.com/health/alarming-number-of-adolescents-have-prediabetes-new-data-from-cdc-says?utm_source=chatgpt.comhttps://x.com/utobian/status/1943127594960064713?t=BfpiRV8m7thZDIqTRMVo3Ahttps://www.medicaleconomics.com/view/health-care-workers-are-leaking-patient-data-through-ai-tools-cloud-appshttps://www.medicaleconomics.com/view/sanders-senators-float-ban-on-direct-to-consumer-ads-for-prescription-drugshttps://newsnetwork.mayoclinic.org/discussion/mayo-clinics-ai-tool-identifies-9-dementia-types-including-alzheimers-with-one-scan/
“That race car you got, that you studied all the components and now you're just tweaking horsepower and how much can you get out of it? That's what this feels like. You are really optimizing the horsepower of this engine, your employee benefit plan, and everybody likes it.” - Bently Durant
This week, I was joined by an all-star duo: Bently Durant, the COO of Classic Chevrolet, which is the #1 Chevy dealer in the world, and his benefits advisor, Riley Dearing of Hotchkiss Insurance.
Together, we discussed the story of how they saved $3 million while simultaneously improving care by eliminating deductibles and optimizing pharmacy spend, which is a playbook that every business owner, CFO, and consultant can learn from. Bently, Riley, and I talked about what makes this industry so unique and why self-funding is so beneficial for car dealerships.
We also dove into the truly innovative things they're doing now that their plan is so successful, like creating a "Good Decision Fund" to give bonus money back to their employees.
Tune in this week to learn how to optimize the horsepower of an employee benefits plan!
Chapters:
(00:00:00) How the World's #1 Chevy Dealer Saved $3 Million on Healthcare
(00:04:10) When Bently Decided To Go Self-Funded
(00:14:08) Tailoring Health Plans To Your Employees
(00:31:19) The Complicated World Of Pharmacy Spend
(00:58:27) Improving The Benefits Plan WHILE Saving Money
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"If employers do not think that they are in the healthcare business, they are sadly mistaken. Every employer is in the healthcare business whether they want to or not." - Stephanie Koch
I’m super excited about this week’s episode: the Empowering Employers live panel show that we recorded in front of a live audience on June 18th. I was joined on-stage by an all-star group of guests: Rachel Strauss, Kimberly Carleson, Kristen Rivers, and Stephanie Koch.
Together, we discussed some of the biggest challenges and opportunities for employers in today’s market; the diversity of perspectives on-stage made this a super insightful podcast, and whether you’re an employer, consultant, or solution provider, there’s a lot you’ll take away.
We also had live Q&A after the main podcast, with some hard-hitting questions from Omar Arif, Elaine Davis, and more.
Tune in this week to learn how we can better empower employers!
Chapters:
(00:00:00) The Empowering Employers Live Show, with Q&A
(00:13:00) How Do We Get More Transparent Healthcare Pricing?
(00:21:25) What Is The PBM’s Role In Better Healthcare Strategies?
(00:29:00) Lowering Healthcare Costs Through Claim Review
(00:40:11) PBM Reform Through Strategic Legal Actions
(00:48:45) How Do We Pay For GLP-1s?
(01:01:22) Live Audience Q&A
(01:38:10) Final Thoughts From Each Panelist
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
"There is no such thing as a health or medical problem for which we are not your partner." - David Silverstein
The U.S. healthcare system is the third-largest economy on the planet, which makes expecting patients to navigate all of its complexities pretty unrealistic. This week’s guest, David Silverstein, is aiming to make healthcare simpler for the end user, steering them when appropriate to the best care and becoming their first point of contact with the healthcare system.
David explains why the system is designed to create friction, from unnecessary tests to proprietary pricing that hides the true cost of care. He also told me about his experience trying to get legislation passed that would make healthcare costs more transparent, and the lobbying groups he ran up against in that attempt.
Tune in this week to learn how we make healthcare simpler for Americans!
Chapters:
(00:00:00) How Do We Make Healthcare Simpler? | with David Silverstein
(00:06:30) Streamlining Healthcare With Modern Tech
(00:12:37) Pushing For More Transparent Healthcare Legislation
(00:22:30) Fair Pricing for Informed Healthcare Decisions
(00:33:37) Virtual Healthcare Navigation and Coordination
(00:59:37) More Transparent Healthcare Costs
(01:15:22) Patient-Centered Healthcare
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“As a broker, our job is counting cards against the system. Because everything catches up 5-10 years later. Every other broker, every other consultant gets in like, oh, that's a great idea. We're always trying to find the next little thing, and then the system eventually shuts it down because it messes with somebody's money." - Taylor Orton
What does it mean to be on the bleeding edge of employee benefits? My next guest, Taylor Orton, CEBS, of Cottingham & Butler, frames the work of a top consultant as “counting cards against the system”, and trying to continuously stay ahead of the market.
Taylor broke down several of the key areas of cost containment that are often employed by brokers and gave his take, as well as what it means to be on the “bleeding edge” of benefits. He also shared with me why cost containment doesn’t just mean lowering the “unit cost” of healthcare; it also means trying to reduce the number of “units”.
Much of this conversation was on the big picture of the healthcare landscape, so if you’re a self-funded geek, this one is for you.
Chapters:
(00:00:00) Why Brokers Need To Be Constantly Innovating | with Taylor Orton
(00:10:44) Optimizing Healthcare Benefits Plans
(00:16:14) Why Procurement Strategies Are So Key To Cost Management
(00:33:22) Market Forces' Impact on Healthcare Pricing
(00:46:54) Employer Transparency About Healthcare
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“There's this ability to impact people directly through the employer in a very cost effective way, giving everyone the chance to improve their health. The more employers that we can impact, the more people we're going to impact." - Erica Armstrong
I recently had the pleasure of speaking with Erica Armstrong, MD, IFMCP, the founder of Root Functional Medicine, who is on a mission to use functional medicine to find and treat the root cause of our health issues. After first connecting with Erica on LinkedIn, I was excited to have her on the show to discuss her holistic approach to healthcare.
We discussed the core pillars of functional medicine, including a nutrition-first care model, the critical importance of a healthy gut microbiome, the keys to inflammation management, and even the potential for reversing chronic conditions. We also cover how she is bringing this new, more comprehensive model to employers and their employees.
Tune in this week to learn all about functional medicine!
Chapters:
(00:00:00) Functional Medicine 101 | with Erica Armstrong
(00:05:37) The “Root Cause” Approach
(00:07:03) Holistic Approach Of Functional Medicine
(00:16:56) Nutrition-First Care
(00:25:59) The Importance Of A Healthy Gut Microbiome
(00:34:46) Chronic Condition Reversal
(00:44:10) The Key To Inflammation Management
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.
Each month on Last Month In Healthcare, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions. This month, we were joined in studio by Shawn Ferguson from Acrisure!
This episode covers healthcare news from May 2025, including:
-
Trump's 'most favored nation' executive order
-
AI in the FDA
-
FDA's plan to review chemicals in our food supply
-
Prices for new drugs doubling in the last 4 years
-
Hospitals outsourcing minor surgeries
-
The DOJ lawsuit against Aetna, Elevance, and Humana
And we play a new game called the Macro Matchup, where Spencer and Shawn attempt to guess the calories, sugar, fat, and protein of 4 very unhealthy fast food items.
Chapters:
0:00 - Intro
1:01 - Healthcare Headlines
18:21 - The Self-Funded Review
31:29 - Macro Match-up (this month's game)
38:06 - Ask Spencer Anything
Sources:
- https://www.healthcaredive.com/news/trump-most-favored-nations-drug-pricing-plan/747761/
- https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-centers-deploy-ai-internally-immediately-2025-05-08/
- https://www.reuters.com/world/us/fda-plans-review-chemicals-us-food-supply-official-says-2025-05-15/
- https://www.reuters.com/business/healthcare-pharmaceuticals/prices-new-us-drugs-doubled-4-years-focus-rare-disease-grows-2025-05-22/
- https://www.healthleadersmedia.com/innovation/healthcare-diversified-hospitals-are-outsourcing-minor-surgeries
- https://www.reuters.com/sustainability/us-files-false-claims-complaint-against-three-health-insurers-2025-05-01/
"I want to be in our own category." - Rob Gelb
I recently joined Rob Gelb, CEO of Vālenz, which is a sponsor of this show, at the Vālenz office in Philadelphia to discuss the story of the company, how it operates in the market currently, and it’s future, which includes the recently announced Vālenz One.
Rob describes VālenzONE as a “health plan optimizer”, and we discussed what that means and what it looks like to build a new way for employers to manage their healthcare. We also discussed the healthcare market as a whole, what it’s currently lacking, and Rob’s general philosophy of how he’s approached building this new platform.
Tune in this week to learn all about VālenzONE!
Chapters:
(00:00:00) What Is VālenzONE? | with Rob Gelb
(00:08:03) How Data Can Reduce Health Plan Spend
(00:19:48) How Vālenz Has Transformed Over The Years
(00:22:43) What Does Optimized Healthcare Look Like?
(00:36:58) Why Integrated Health Solutions Are The Future
(00:41:34) Innovative Healthcare Collaborations
(00:50:17) What Does It Mean To Be Innovative?
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“We show…very similar weight loss outcomes to GLP1 in a similar timeframe at a fraction of the cost, but sustainable through behavior change." - Colin Rogers
Colin Rogers, VP at Signos, joined me for episode 200! On this special episode, we talked about something I’m very passionate and vocal about: weight loss for everybody.
Signos combines continuous glucose monitors (CGMs), our phones, and AI to track longitudinal data and help educate and prompt members to make better health decisions. If you’re into personalized population health, then this is the episode for you!
On one of our earliest episodes, a guest shared that the best way to solve the problem of healthcare is to produce less disease. GLP-1s definitely appear to have a role to play in that, but as Colin shares on this episode, the more we can achieve GLP-1 results in a way that’s sustainable, the better, for employers and for America.
Chapters:
(00:00:00) GLP-1 Weight Loss At A Fraction Of The Cost | with Colin Rogers
(00:11:29) Real-world CGM Data Impact
(00:15:26) Health Programs for Metabolism Control
(00:21:37) Real-time Glucose Monitoring Devices Empower Employees
(00:36:03) How CGMs Can Optimize A Health Plan
(00:42:05) Why This Data Is So Powerful
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“You know, Marshall was known in the healthcare space, but there's 100 million Americans who don't know anything about the healthcare space. And those are the people that we're really trying to serve." - Sonja Allen
Sonja Allen is the Managing Director of the Marshall Allen Project and the Allen Health Academy, and as many of you know, she was also married to our dear friend, the late Marshall Allen. Sonja joined me to discuss how she’s continuing Marshall’s mission of helping Americans fight back against our healthcare system, using the MAC, an AI clone of Marshall Allen.
She also shared the story of her and Marshall’s lives together, including how they met and how he found his passion for healthcare journalism, and I’m humbled to have had the chance to capture a permanent record of it for the world.
Marshall was a dear friend and an inspiration, and I was honored to have him on the show. I hope you’ll tune in this week to hear how we can all continue his legacy.
Chapters:
(00:00:00) Continuing Marshall Allen's Legacy | with Sonja Allen
(00:03:40) Sonja’s Experience Growing Up In Kenya
(00:08:43) Meeting Marshall Allen
(00:16:04) Marshall’s Career Transformation
(00:30:58) The MAC - The Marshall Allen AI Clone
(00:33:53) Empowering Healthcare Navigation Using The MAC
(00:42:55) Informing Americans Of Their Healthcare Rights
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“That's the great thing about upfront, all inclusive, transparent specialty care is you eliminate all of that, right? You purchase the service, you never see another bill from it again. You're done." - Dean Jargo
Dean Jargo, CEO of Fair Market Health, joined me this week to share why US healthcare desperately needs to be a fair market.
We talked about what that means and why it requires us to construct a new healthcare ecosystem, how it enables patients to actually receive better care at a lower price point, and how it can work in conjunction with employer benefits to create a more effective system for employers, employees, and providers.
Join us this week on Self-Funded with Spencer as we talk the big-picture future of healthcare!
Chapters:
(00:00:00) Returning Healthcare To The Free Market | with Dean Jargo
(00:03:50) Streamlining Healthcare Payments
(00:10:02) Directly Purchasing Specialty Care
(00:16:00) Why Healthcare Desperately Needs A Fair Market
(00:21:44) Transparent Pricing Model
(00:26:23) Creating A New Healthcare Ecosystem
(00:53:12) Clear Pricing Leads To Informed Healthcare Purchases
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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/
“Some of the most expensive real estate is healthcare real estate. And so by pulling that out of our business model, it allows us to bring care in a very convenient way directly into the homes of our patients." - Jory Zunich
This episode combines two topics we speak about frequently on Self-Funded: making healthcare more affordable, and improving access to care for employees. Jory Zunich of Nice Healthcare joined me to explain how Nice is able to provide in-home healthcare affordably, and how their model can potentially revolutionize primary care.
We discussed how Jory got into healthcare and his track-and-field background before talking about Nice, and how simply removing the element of real-estate costs can make in-home care cheaper in some cases. Jory shared how his kids have only ever experience in-home care, and why that convenience is powerful.
Chapters:
00:00:00 How Nice Healthcare Provides Affordable In-Home Healthcare | with Jory Zunich00:20:05 The Power Of Virtual Healthcare00:30:58 How In-Home Care Can Actually Be Cheaper00:40:11 Convenient In-Home Labs00:40:57 Streamlined Patient Navigation in Primary Care00:42:29 Cost-Effective Healthcare Solutions
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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 want other people to know that, like, there's nothing wrong with you. If you have mental health issues, there's help for you and there's life on the other side." - Sims Tillirson
This is the second part of my conversation with Sims Tillirson, the first of which released this Tuesday. In this episode, we focused on Sims’ openness about his mental health issues on LinkedIn, his struggle to get off of antidepressants, and destigmatizing conversations about mental health, especially among men. Sims also shared some tips for men who have friends struggling mentally, and how we can all do a better job supporting each other.
This episode is pretty distinct from the first, and from most episodes of Self-Funded, but it was an important conversation to be had, and I hope you’ll tune in.
Chapters:
00:00:00 Helping Each Other Through Mental Health Struggles | with Sims Tillirson
00:00:32 Destigmatizing Mental Health
00:03:15 How Do We Increase Access To Mental Healthcare?
00:06:14 The Power of Genuine Listening
00:09:54 Holistic Approach to Medication and Mental Healthcare
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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:
Mental Health Awareness, Mens Mental Health, Break The Stigma, Empathetic Listening, Antidepressants, Mindfulness, Depression, Supporting Others, Alternative Therapies, sims tillirson, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
MentalHealthAwareness #MensMentalHealth #BreakTheStigma #EmpatheticListening #Antidepressants #Mindfulness #Depression #SupportingOthers #AlternativeTherapies #simstillirson #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
“If you've shied away from showing who you are because you fear that you'll lose sales: people that would not like the authentic version of you are not going to be good customers of you anyway. Put yourself out there, disqualify the people that don't like the real you, and create a bunch of raving fans for yourself." - Sims Tillirson
I would honestly be surprised if you listen to this show and haven’t heard of Sims Tillirson; he has one of the best social media presences of anyone in the benefits industry, and he joined me this week to share what got him into benefits, how he got started with social media selling, and his thoughts on the importance of authenticity in the current LinkedIn environment.
If you’re just getting started with social media posting or you’ve been posting for a while, there’s a lot to learn from Sims and I’ve been continually impressed to see how his personal brand has grown over the years.
Tune in to this week’s episode of Self-Funded with Spencer to learn the power of being authentic on LinkedIn, from the social media master himself!
Chapters:
00:00:00 The Four Pillars of the Perfect LinkedIn Strategy | with Sims Tillirson
00:06:57 How Sims found his way into benefits
00:11:13 Navigating the challenges of working at startups
00:21:21 How Sims built his personal brand
00:24:35 Why personalized video messages are so effective
00:27:03 Relationship-focused outbound sales techniques
00:28:54 Building trust through social media
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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:
Sales Techniques, Sales Networking, Social Media Selling, Authenticity, Personal Storytelling, Video Messaging, Outbound Sales, Social Selling, Benefits Industry, Sales Success, Social Media Presence, sims tillirson, spencer smith podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
SalesTechniques #SalesNetworking #SocialMediaSelling #Authenticity #PersonalStorytelling #VideoMessaging #OutboundSales #SocialSelling #BenefitsIndustry #SalesSuccess #SocialMediaPresence #simstillirson #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.
This month, we were joined by Rob Gelb in his office in Philadelphia!
Welcome to Last Month In Healthcare! Each month, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.
This episode covers healthcare news from April 2025, including:
-
RFK banning artificial food dyes
-
Phasing out animal testing
-
The amount of microplastics in our brains
-
An update on the FTC lawsuit against PBMs
-
Can AI answer medical questions better than your doctor?
-
Bill Gates on AI doctors/teachers
-
The UnitedHealth stock crash
-
Heavy metals in Girl Scout cookies
And, we play a game of "Medical Myths."
Chapters:
0:00 - Intro
0:47 - The Self-Funded Review
7:44 - Healthcare Headlines
33:11 - Medical Myths
35:12 - Ask Spencer Anything
Sources:
https://www.fda.gov/news-events/press-announcements/fda-announces-plan-phase-out-animal-testing-requirement-monoclonal-antibodies-and-other-drugs
https://www.health.harvard.edu/blog/can-ai-answer-medical-questions-better-than-your-doctor-202403273028
https://www.instagram.com/breakfreefromplastic/p/DGBbTB5z48n/
https://www.barrons.com/articles/unitedhealth-stock-falls-medicare-advantage-6c54e1c1
https://www.reuters.com/business/healthcare-pharmaceuticals/unitedhealth-lowers-annual-profit-forecast-higher-costs-2025-04-17/
https://unusualwhales.com/news/bill-gates-says-ai-will-replace-doctors-and-teachers-in-10-years
https://www.nbcnews.com/health/health-news/rfk-jr-announces-plans-remove-artificial-dyes-nations-food-supply-rcna202184
https://www.healthcaredive.com/news/ftc-pbm-case-move-forward-ferguson/744454/
"Automating those healthy habits is essential." - Chris Burgess
Chris Burgess is the creator of the app Affili-Fit, which creates custom workout and diet plans for its users. We talked about what led him to create this app, how it sets itself apart in that market, and how he’s working with employers to use the app for employee wellness programs.
Chris never intended to start an app, and he shares what the experience has been like from initial idea, to taking on investment, and now expanding in different markets. We talked about the psychology behind paid vs. free apps, what he sees as the future for Afiili-Fit, and how it’s found success with its users.
Tune in this week to learn about a fitness and diet app for employee wellness!
Chapters:
00:00:00 A Fitness And Diet App For Employee Wellness | with Chris Burgess
00:06:07 Chris’s Construction Background
00:21:32 Automated Meal Planning/Nutrition App
00:31:26 Using AI To Help Build Meal Plans
00:37:29 Helping Users Meet Their Health Goals
00:48:35 How Affilifit Can Be Used For Employee Wellness
01:06:09 Employer-Sponsored Fitness Plans
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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:
Construction, Nutrition App, Affilifit, Meal Planning, Employee Wellness, Custom Workout, diet app, exercise app, fitness app, wellness, diet, nutrition, fitness, exercise, chris burgess, spencer smith, podcast, healthcare, health insurance, self funded, selffunding, self funded health insurance, self funded insurance
Construction #NutritionApp #Affilifit #MealPlanning #EmployeeWellness #CustomWorkout #dietapp #exerciseapp #fitnessapp #wellness #diet #nutrition #fitness #exercise #chrisburgess #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
“Each acquisition has its own fingerprints. You kind of think, oh, it's an acquisition. No, it's all different.” - Diane Dooley
Diane Dooley, a CHRO and consultant, joined me this week to discuss what HR’s role in mergers & acquisitions is, and why HR is so key to that process. We talked about doing the right due diligence before an acquisition, how to merge cultures, and how to navigate the different reactions that employees inevitably have.
Diane and I also dove into the psychology of both the buyer and the seller in an M&A transaction, and why the reasons to buy are often not the same as those to sell. Founders often have much more emotions surrounding the transaction, which have to be taken into account to make sure the transition is as smooth as possible for them and their employees.
Join me this week on Self-Funded with Spencer to find out what HR’s role is in the M&A process!
Chapters:
00:00:00 HR’s Role In M&A: Due Diligence, Culture, and Integration | with Diane Dooley
00:08:08 Assessing Cultural Fit in M&A
00:15:49 Thorough Due Diligence When Acquiring
00:20:52 Impact of Company Culture in Mergers
00:25:26 Navigating Integration With Change Management
00:39:17 Leadership Continuity
00:41:54 The Importance of Employee Incentives
00:46:37 Avoiding Hiring Mistakes
01:06:51 Being Proactive In HR
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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:
HR, Mergers And Acquisitions, M and A, Mergers, Acquisitons, CHRO, Due Diligence, Culture, Integration, Change Management, Succession, Recruitment, Diane Dooley, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
HR #MergersAndAcquisitions #MandA #Mergers #Acquisitons #CHRO #DueDiligence #Culture #Integration #ChangeManagement #Succession #Recruitment #dianedooley #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"If you're an employer, if someone comes up and knocks on your door, take a second, breathe, and listen to what they have to say." - Christopher Cordon
Christopher Cordon joined me this week to talk about something that may initially seem contradictory to what I typically preach: level-funding. Chris shares why worksite benefits sales for employers with under 50 employees led him to level-funding as a solution, and why he’s so passionate about serving that under-served market.
Chris has a background as an actor, and we also discussed how that has helped him in sales and in the entrepreneurial world, as well as in his recent LinkedIn content.
Chris is a passionate guy who genuinely wants to make insurance affordable and easy for small employers, and I hope you’ll tune in to hear just how he does that.
Chapters:
00:00:00 Health Insurance Benefits With Less Than 50 Employees | with Christopher Cordon
00:08:37 Chris’s Career Path
00:23:56 Learning How To Navigate Sales
00:33:45 Why Large Employers Are Almost All Self-Funded
00:44:33 The Efficiency and Cost-Effectiveness of Direct Primary Care
00:48:21 Why Chris Has Embraced Level-Funding
00:52:59 Simplifying Self-Insurance
01:01:51 How Do We Make Healthcare Sustainable?
01:10:27 AI's Impact on Healthcare Costs
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen/watch 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:
Direct Primary Care, DPC, Level Funded, Level Funding, Employer Solutions, Healthcare Consulting, Insurance Business, AI in Healthcare, entrepreneurship, christopher cordon, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
DirectPrimaryCare #DPC #LevelFunded #LevelFunding #EmployerSolutions #HealthcareConsulting #InsuranceBusiness #AIinHealthcare #entrepreneurship #christophercordon #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"If you know how a PBM gets paid, that's the best transparency you can ask for.” - Julie Wasserman
Julie Wasserman, VP of Sales for VerusRx, joined me this week to discuss the PBM industry in 2025. If you’re a PBM, how do you gain trust with employers and build plans that work for them? We talk about what every PBM should be doing for their employers, what true transparency looks like, how to reach employees directly through software, and how GLP1s are changing the industry.
If you’re a PBM or work with them, or are just curious about one of the biggest industries in healthcare, make sure to tune in this week to Self-Funded with Spencer to hear from Julie on what the best practices need to look like.
Chapters:
00:00:00 What The PBM Industry Should Focus On In 2025 | with Julie Wasserman
00:15:07 Increasing Employee Engagement
00:20:16 Complexity in the PBM Industry
00:25:03 Data-Driven Health Savings for Employers
00:31:27 What Does True Transparency Look Like
00:49:36 Global Drug Price Discrepancies
00:56:38 Incentivizing Cost-Effective Healthcare Decisions in PBMs
01:01:11 Financial Risks of Covering GLP1s for Weight Loss
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:
VerusRx, PBM, PBMs, Rebate, Rebates, Pharmacy Rebates, Transparency, PBMIndustry, GLP1, GLP1s, Ozempic, Wegovy, pharma, Reference Based Pricing, RBP, Healthcare Costs, julie wasserman, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
VerusRx #PBM #PBMs #Rebate #Rebates #PharmacyRebates #Transparency #PBMIndustry #GLP1 #GLP1s #Ozempic #Wegovy #pharma #ReferenceBasedPricing #RBP #HealthcareCosts #juliewasserman #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.
Last Month In Healthcare is officially a video podcast! Each month, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.
This episode covers healthcare news from March 2025, including:
-
Marty Makary getting confirmed to lead the FDA
-
The HHS restructuring, including 10,000 job cuts
-
Texas's response to the MAHA commission
-
Operation Stork Speed, aiming to make baby formula safer and healthier
-
The potential ban on soda/candy for those on food stamps
-
Increasing cybersecurity risks for healthcare providers
And, we play a game of "AI Company, Healthcare Company, or Metal Band?"
Chapters:
0:00 - Intro
1:10 - The Self-Funded Review
5:38 - Healthcare Headlines
23:13 - AI Company, Healthcare Company, Or Metal Band?
25:17 - Outro
Sources:
- https://www.upi.com/Top_News/US/2025/03/26/Senate-confirms-Marty-Makary/7901742973955/
- https://www.hhs.gov/about/news/hhs-restructuring-doge.html
- https://texasscorecard.com/state/texas-senators-tackle-maha-agenda/
- https://www.newsnationnow.com/health/rfk-jr-baby-formula-operation-stork-speed/
- https://www.politico.com/news/2025/03/27/rfk-jr-food-stamps-soda-usda-tension-00252045
- https://www.hipaajournal.com/himss-survey-healthcare-cybersecurity-2024/
- https://www.theregister.com/2025/03/06/rural_hospitals_cybersecurity/
- https://www.fiercehealthcare.com/health-tech/private-equity-takeover-healthcare-firms-need-cybersecurity-vigilance-report
- https://www.hipaajournal.com/healthcare-data-breach-statistics/
- https://globalventuring.com/corporate/healthcare/us-hospitals-bump-up-tech-investments-as-healthcare-crises-widen/
- https://www.discogs.com/lists/Underrated-Obscure-And-Cult-Heavy-Metal-bands/313760?page=7
- https://builtin.com/artificial-intelligence/ai-companies-roundup https://www.glassdoor.com/Explore/browse-companies.htm?filterType=RATING_OVERALL&locId=1&locType=N&locName=United-states§or=10012&page=15&overall_rating_low=4
"Insurance is about health and wealth. It protects your health, it should protect your wealth." - Kylie Everhart
Kylie Everhart, Chief Growth Officer at Oxbridge Health, joined me to discuss episode benefit plans and how they empower consumers to make better healthcare choices. Episode benefit plans bundle pricing for the entirety of an “episode of care” - for example, if you need a knee surgery, an episode benefit plan would figure out the cost of everything involved in that procedure from several different providers in your area, and offer you multiple bundled price points to choose from.
Americans deserve to know the price of their healthcare upfront so that they can make informed decisions. As Kylie shares in the episode, once people have transparent pricing on medical procedures, they demand it from any healthcare plan they use in the future.
Tune in this week to Self-Funded with Spencer for a new method of empowering consumers to make good healthcare choices.
Chapters:
(00:00:00) Empowering Americans To Shop For Their Healthcare | with Kylie Everhart
(00:05:22) Consumerism In Healthcare
(00:23:59) Connecting Patients To Cost-Effective Care
(00:28:02) The Balance of Technology and Human Connection
(00:29:44) Data-Driven Solutions for Employer Healthcare Costs
(00:42:17) What Are Episode Benefit Plans?
(00:57:21) Transparent Pricing Empowers Consumers
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 Choice, Employer Healthcare, Healthcare Plans, Episode Benefit Plans, Oxbridge, Empowering Consumers, Consumer Healthcare, Healthcare Consumerism, Healthcare Transparency, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
HealthcareChoice #EmployerHealthcare #HealthcarePlans #EpisodeBenefitPlans #Oxbridge #EmpoweringConsumers #ConsumerHealthcare #HealthcareConsumerism #HealthcareTransparency #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"I think innovation is supposed to be hard. That's why it's innovation.” - Seth Denson
“Better consumption requires a lot more education.” - Trey Marinello
"Don't compare GLP-1s to working out, because if they were working out, they wouldn't need the GLP1s." - Danish Nagda
“I think what RFK has done with the MAHA movement is he's gotten people interested in health again.” - Jonathan Lopez
Seth Denson, Trey Marinello, Danish Nagda, and Jonathan Lopez joined me for the most ambitious podcast we’ve ever attempted. On location in the Red Phone Booth speakeasy in The Colony, Texas, 35 guests joined us from across the United States to share ideas to shape the future of healthcare. In my longest podcast ever, we covered the doctor shortage in America, GLP-1s, AI’s role in healthcare, answered live audience questions, and so much more.
This podcast was made possible by Havencrest Capital Management and True Rx Health Strategists. Special thank you to Sawyer Stratton.
No matter what role you play in our healthcare ecosystem, I promise that you’ll learn something from these four amazing guests I had on this week’s episode of Self-Funded with Spencer.
Chapters:
00:00:00 The Future Of Healthcare Podcast
00:11:31 Solving The Healthcare Provider Shortage
00:16:49 AI’s Role In Healthcare
00:23:01 Enhancing The Healthcare Consumer Experience
00:29:27 Empowering Individuals in Healthcare Decision-Making
00:32:20 PBMs Role In Healthcare
00:39:06 GLP-1 Concerns
00:51:02 Improving Patient Outcomes
01:13:05 Audience Q&A
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 Innovation, Future Of Healthcare, Doctor Shortage, Care Navigation, GLP1, Ozempic, PBMs, Healthcare Incentives, MAHA, make america healthy again, rfk, jonathan lopez, danish nagda, seth denson, trey marinello, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
HealthcareInnovation #FutureOfHealthcare #DoctorShortage #CareNavigation #GLP1 #Ozempic #PBMs #HealthcareIncentives #MAHA #makeamericahealthyagain #rfk #jonathanlopez #danishnagda #sethdenson #treymarinello #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"Our business is predicated on two things: consolidating things that would otherwise be disparate, and then using that as a trusted chassis to communicate and engage effectively." - Ryan Coplon
Ryan Coplon, co-founder of HealthWallet, joined me to discuss why improving member engagement actually reduces health plan expenses, how we get members to understand their healthcare, and what the “perfect” employer health plan would look like.
In my opinion, solutions like HealthWallet are something of a no-brainer if you’re an employer; you can implement amazing, cost-containing point solutions, but if your employees don’t know how to access them, they aren’t going to when they access care. Ryan and I talk about the importance of accessibility and empowering consumers to make the right choices with their care.
Tune in this week to learn how to simplify the way employees access their healthcare!
Chapters:
00:00:00 Fixing The Way Employees Access Healthcare with Ryan Coplon
00:14:26 Re-bundling Disparate Services To Improve Member Experience
00:19:50 Enhancing Member Engagement
00:21:28 Integrated Healthcare Reduces Expenses
00:31:50 Healthcare Simplification
00:46:45 Transitioning to Digital Member IDs
00:52:49 Building the Perfect Health Plan
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:
Member Experience, Health Wallet, Health Plans, Member Access, Accessing Healthcare, Digital ID, Direct Primary Care, Emergency Care Navigation, Care Navigation, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
MemberExperience #HealthWallet #HealthPlans #MemberAccess #AccessingHealthcare #DigitalID #DirectPrimaryCare #EmergencyCareNavigation #CareNavigation #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.
Welcome to our new monthly podcast series, Last Month In Healthcare! Each month, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.
This episode covers healthcare news from February 2025, including:
-
the start of the Make America Healthy Again commission
-
executive orders to make healthcare prices more transparent
-
beef tallow fries at Steak 'n Shake
-
telehealth advertising and GLP-1 statistics
-
the FTC lawsuit against huge PBMs
-
American's wariness about AI in healthcare
-
allowing AI to prescribe medicine
-
a bipartisan bill to allow HSA dollars to be used for direct primary care
Chapters:
0:00 - Intro
1:09 - The Self-Funded Review
8:40 - Healthcare Headlines
30:40 - Ask Spencer Anything
Sources:
https://www.yahoo.com/news/america-healthy-again-timeline-maha-093054800.html
https://www.whitehouse.gov/presidential-actions/2025/02/establishing-the-presidents-make-america-healthy-again-commission/
https://www.whitehouse.gov/fact-sheets/2025/02/fact-sheet-president-donald-j-trump-announces-actions-to-make-healthcare-prices-transparent/
https://www.medscape.com/viewarticle/this-bill-could-make-it-legal-ai-prescribe-medicine-2025a1000504?utm_campaign=feed&utm_medium=referral&utm_source=later-linkinbio&form=fpf
https://www.benefitspro.com/2025/02/28/want-glp-1-coverage-workers-willing-to-switch-jobs-for-access/
https://kffhealthnews.org/news/article/telehealth-ads-marketing-birth-control-mental-health-obesity/
https://healthexec.com/topics/healthcare-management/legal-news/federal-judge-sides-ftc-case-against-pbms-move-forward
https://thenationaldesk.com/top-videos/facing-burnout-us-doctors-see-hope-in-ai-for-better-patient-care-artificial-intelligence-athenahealth-survey-staffing-shortages-reimbursement-electronic-health-records-billing
https://www.dermatologytimes.com/view/study-reveals-majority-of-us-adults-distrust-health-care-system-s-use-of-ai
https://crenshaw.house.gov/2025/2/crenshaw-co-leads-bipartisan-legislation-expanding-direct-primary-care-access
"I think that's the difference with a contagious community. Like, I want to bring other people that I like into this community." - Scott Smith
Scott Smith, President of True Network Advisors, joins the show for a third time for this podcast filmed at his boathouse in Guntersville, Alabama.
Scott and I talked about contagious communities, which Scott defines as a community that people want to share with other people in their life. We also talked about Scott’s list of paradoxes, why he calls his wife “Miss Hot Dog”, creating genuine relationships in life and business, and why authentic expression is so important to both of us.
This is the longest podcast we’ve ever released, but also one of the most engaging, and Scott is always a fascinating person to talk to.
Tune in this week to Self-Funded with Spencer to learn about what it takes to create a contagious community!
Chapters:
00:00:00 How to Build a Contagious Community | with Scott Smith
00:12:19 What’s in a name?
00:16:36 Scott’s definition of a “contagious community”
00:24:46 Organic growing an engaging community
00:36:27 Cultivating positive community experiences
00:40:09 Building a culture of kindness
00:46:33 Creating genuine relationships in business and life
00:57:48 Should we worry about our own legacies?
01:06:29 Dealing with the negativity that comes with building anything
01:16:37 Why authentic expression is so important
01:23:10 The burden of choice
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:
Contagious Community, Contagious Communities, Creating Communities, Community Building, Relationship Building, Legacy, Free Speech, Paradox Of Choice, Positive Communities, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
ContagiousCommunity #ContagiousCommunities #CreatingCommunities #CommunityBuilding #RelationshipBuilding #Legacy #FreeSpeech #ParadoxOfChoice #PositiveCommunities #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"Reversing obesity, reversing diabetes is possible. You don't just have to manage a chronic condition." - Steve Hastings
Steve Hastings, Leader of Health Plans at Virta Health, joined me to share Virta’s strategy to help members reverse type 2 diabetes, prediabetes, and obesity. He also shared their findings on just how important food is to our overall health and the power it has as medicine.
If you’ve listened to pretty much any episode of Self-Funded with Spencer, you’ve heard my thoughts on the importance of healthy nutrition and eating, and how so many of America’s chronic health problems are due to what we eat. Steve shared how they put together effective plans that actually work to help people lose weight, and keep it off, without using GLP-1s or other drugs. And, if a member needs GLP-1s, they work to create a strategy to make sure the drug is effective and they can maintain that weight loss.
Join us on Self-Funded this week to learn how it’s possible to reverse diabetes and obesity!
Chapters:
00:00:00 Meet Steve Hastings
00:02:53 Food As Medicine
00:07:47 Membership-based Primary Care
00:15:29 Nutrition-Based Reversal of Diabetes and Obesity
00:17:35 America’s Obesity Health Crisis
00:20:03 Long-term Health Goal Support
00:27:42 Tailored Nutrition Plans To Reverse Diabetes
00:35:55 Mental Health Improvement From Weight Loss
00:49:00 Optimizing Health Outcomes Through Food
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:
Nutrition, Primary Care, Reversing Diabetes, Reversing Obesity, Diabetes, Obesity, Obesity In America, Behavior Change, Individualized Nutrition, GLP1s, GLPs, Ozempic, semiglutides, Food As Medicine, Wellness, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
Nutrition #PrimaryCare #ReversingDiabetes #ReversingObesity #Diabetes #Obesity #ObesityInAmerica #BehaviorChange #IndividualizedNutrition #GLP1s #GLPs #Ozempic #semiglutides #FoodAsMedicine #Wellness #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"If you're not going to be excited when I'm calling you, we're probably not a mutual fit." - Maggie Quinn
Maggi Quinn, SVP of Consulting at Intrepid Benefits, joined me to discuss working at an all-female insurance agency, why specialization is so important in today’s market, and some innovative approaches to self-funded healthcare.
Maggi shares her journey into insurance, as well as how she found her way to Intrepid, and why the relationship side of the business is the most important to her. We also discuss what makes Intrepid so different, and how that’s won (and lost) them business over the years.
Tune in this week to Self-Funded with Spencer to learn why I gave Maggi the name “Maggi Quinn, Benefits Woman”.
Chapters:
00:00:00 Meet Maggi Quinn
00:11:18 Maggi’s Journey To Intrepid
00:22:11 Enhancing Employer Healthcare
00:26:09 Customized, Personal Solutions For Employers
00:31:06 Mutual Fit in Client Relationships
00:37:11 Enhancing Client Understanding in Healthcare Communication
00:39:18 Personalized Medication Management through DNA Sequencing
00:42:39 Enhancing Well-being Through Health Education
00:55:14 Innovative Approaches To Employer-sponsored 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 Solutions, Wellness, Personalized Medication, Client Relationships, Innovative Healthcare, Self Funded Employers, Specialized Healthcare, Future Of Healthcare, Cost Effective Healthcare, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
HealthcareSolutions #Wellness #PersonalizedMedication #ClientRelationships #InnovativeHealthcare #SelfFundedEmployers #SpecializedHealthcare #FutureOfHealthcare #CostEffectiveHealthcare #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
"Be kind, be focused on others, be a steward of your craft and take the opportunity to take action.” - Sean Wood
Sean Wood, SVP of National Partnerships at ParetoHealth, joined me for a podcast that is far less about captives than it is about being a sales ninja. We talk about getting started in sales, the buyer as a skeptic, collaborative selling, and sales mentorship.
Sean was actually a pro basketball player, and he shares how his point guard experience has translated to his career. He shares what led him into sales and why he embraced it so quickly, and why Pareto felt like a natural fit when he joined.
Whether you’re just getting started in sales or you’re a sales veteran, I promise you’ll learn something from this week’s episode of Self-Funded with Spencer.
Chapters:
00:00:00 Meet Sean Wood
00:04:16 Elevating Your Team As A Leader
00:11:04 Transitioning From Pro Basketball To Sales
00:20:04 Trust-Based Team Selling
00:24:11 Long-term Relationship Building In Sales
00:31:30 The Importance Of Sales Mentorship
00:53:09 Healthcare Solutions Driven By The Market
00:59:57 The Future Of Healthcare Consulting
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:
Transition To Sales, Collaborative Selling, Team Sales, Mentorship, Relationship Building, Sales Process, Healthcare Solutions, Buyer Mentality, Sales Success, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance
TransitionToSales #CollaborativeSelling #TeamSales #Mentorship #RelationshipBuilding #SalesProcess #HealthcareSolutions #BuyerMentality #SalesSuccess #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance
“Whatever your clients find attractive about you and the reason they want to work with you is the exact same reason that a buyer is going to find you attractive and want to acquire your agency.”- Shelby Cowley
Shelby Cowley joined me this week to discuss the complicated world of insurance mergers & acquisitions. How do you get the best valuation for your agency? What key metrics are most attractive to buyers? How much does personality impact the value?
We answer all of those questions and more on this week’s episode of Self-Funded.
Chapters:
00:00:00 Meet Shelby Cowley
00:08:51 Empowering Entrepreneurs through Unique Insurance M&A
00:11:42 Valuation Impact on Agency Acquisition Success
00:15:46 High Demand Driving Top-Tier Valuations in Acquisitions
00:19:29 Strategic Evaluation for Successful Business Acquisitions
00:22:18 Long-term Partnership Potential in Buyer Selection
00:28:45 Performance-Based Growth In Business Sale Agreements
00:37:57 Leveraging Private Equity for Growth and Acquisitions
00:42:15 Maximizing Acquisition Value Through Seller's Representation
00:45:18 Value-Driven Consulting in Client Relationships
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 Mergers, Mergers And Acquisitions, Business Sales, Sales, Business Acquisition, Market Dynamics, Transactions, Private Equity Deals, PE, Private Equity, Buyer Selection, Earn Out Period, Seller Representation, Consultant, Insurance Industry, Broker, Representative, Valuations, Growth Strategies, Transaction Goals, Employee Benefits, fixing healthcare, podcast, benefits, health, healthcare, health insurance, self funded, self funding
InsuranceMergers #MergersAndAcquisitions #BusinessSales #Sales #BusinessAcquisition #MarketDynamics #Transactions #PrivateEquityDeals #PE #PrivateEquity #BuyerSelection #EarnOutPeriod #SellerRepresentation #Consultant #InsuranceIndustry #Broker #Representative #Valuations #GrowthStrategies #TransactionGoals #EmployeeBenefits #fixinghealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
“Organ transplant is not something that the employer or even the TPAs are necessarily all experts in." - Guy Finley
“There are still going to be some situations and some events inside that episode of care that are going to be stop-loss related, so we want the two to work together.” - Robby Kerr
Guy Finley and Robby Kerr from HCC joined me in studio for this week’s episode of Self-Funded to discuss covering organ transplants. The costs associated with and frequency of these procedures have greatly increased in recent years, and Guy and Robby share HCC’s strategy to separately insure transplants.
Before jumping into the world of organ transplants, we talked about Guy and Robby’s backgrounds and how they made their way to HCC, as well as each of their roles currently. I was interested to learn why organ transplants became such a passion project for Guy, and how covering them is similar to other high-cost expenditures like specialty drugs.
Join us this week to get an education on organ transplant policy and the best way to cover them in today’s market!
Chapters:
00:00:00 Meet Guy Finley and Robby Kerr
00:07:52 Organ Transplant Insurance
00:13:05 Rising Costs of Transplant Procedures
00:17:31 Comprehensive Coverage for Potential Transplants
00:21:56 Transplant Coverage Financial Assessment
00:27:11 Transplant Nurse Advisors
00:33:24 Transplant Policy Evaluation and Underwriting Process
00:37:26 Rising Liver Transplant Numbers
00:47:42 Innovative Risk Mitigation in Gene Therapy
00:50:17 Rising Rates of Organ Transplants Nationwide
00:59:41 Empowering Consumers Through Healthcare Price Transparency
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 industry, organ transplant, transplants, transplant, transplant insurance, healthcare costs, risk mitigation, transplant coverage, care coordination, stop loss, price transparency, financial planning, Employee Benefits, fixing healthcare, podcast, benefits, health, healthcare, health insurance, self funded, self funding
insuranceindustry #organtransplant #transplants #transplant #transplantinsurance #healthcarecosts #riskmitigation #transplantcoverage #carecoordination #stoploss #pricetransparency #financialplanning #EmployeeBenefits #fixinghealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
“It's everything. Exposure, knowledge, education, generating new business, solving clients, risk management objectives. It's all here." - John Capasso
“And the question comes up year over year, what is the ROI of SIIA? Did we have a legitimate hard dollar return on investment? And the answer is yes, we've always seen a return.” - Amy Gasbarro
This week’s episode of Self-Funded was recorded at the SIIA National Conference in September 2024. I spoke on-stage with Amy Gasbarro and John Capasso about their work at SIIA, what SIIA’s legislative efforts have looked like in recent years, and some practical networking tips for anybody attending a SIIA event.
Along the way, we also dive into the history of SIIA, what’s made it so relevant for so long, and what the real ROI is for both the attendees and the sponsors. At the end of the podcast, we have a Q&A with the audience.
Thank you to SIIA for sponsoring this special edition of the podcast!
Chapters:
00:00:00 Self-Funded At SIIA
00:07:44 Amy and John’s Work At SIIA
00:11:09 SIIA’s Legislative Efforts
00:18:29 Practical Tips For Insurance Conference Networking
00:27:26 AI Discussions At SIIA
00:36:50 Collaborative Networking At SIIA
00:41:10 The Real ROI Of SIIA Sponsorship
00:45:40 The Educational Opportunities At SIIA
00:50:09 Q&A
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:
SIIA, Insurance Conference, Advocacy, Networking, SIIA Conference, Self Insurance, Sponsorship, Event Planning, Industry Education, Legislation, ROI, Self Insurance Community, Employee Benefits, podcast, benefits, health, healthcare, health insurance, self funded, self funding
SIIA #InsuranceConference #Advocacy #Networking #SIIAConference #SelfInsurance #Sponsorship #EventPlanning #IndustryEducation #Legislation #ROI #SelfInsuranceCommunity #EmployeeBenefits #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"If we're not accessible to you, we can't help you." - David Kinzler
David Kinzler, CEO of One-to-One Health, joined me this week to talk about the importance of primary care, restoring the doctor-patient relationship, and TextCare, which provides text messaging access to a dedicated care team with response times under 5 minutes.
David is a former Marine, and spent a few years in US politics before joining the healthcare world, and eventually leading One-to-One. His key focus is simplifying healthcare, meeting patients where they’re at, and re-centering the healthcare experience around the primary care doctor. We’re failing patients in the current system, and David and I discuss the potential solutions.
Chapters:
00:00:00 Meet David Kinzler
00:08:12 Healthcare Cost Management
00:20:19 Enhancing Primary Care
00:27:09 Significance of Relationship-Based Primary Care
00:29:48 Primary Care Leads To Better Outcomes
00:32:34 The Power Of Texting With Patients
00:46:29 Making Healthcare More Accessible
00:59:32 Mental Healthcare Access
01:09:57 Employers Influencing The Future Of 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:
Primary Care, family doctor, Primary Care Access, Healthcare Innovation, Employer Sponsored Plans, Patient Engagement, Text Care, Healthcare Transformation, Mental Health, Primary Care Relationships, employer healthcare, Accessible Healthcare, Fiduciary Services, Employer Driven Change, healthcare access, employer healthcare, Employee Benefits, fixing healthcare, podcast, benefits, health, healthcare, health insurance, self funded, self funding
PrimaryCare #familydoctor #PrimaryCareAccess #HealthcareInnovation #EmployerSponsoredPlans #PatientEngagement #TextCare #HealthcareTransformation #MentalHealth #PrimaryCareRelationships #employerhealthcare #AccessibleHealthcare #FiduciaryServices #EmployerDrivenChange #healthcareaccess #EmployeeBenefits #fixinghealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"The problem with a lot of healthcare is everybody is coming in, making their own solution. So you have thousands of point solution vendors and all we're doing is confusing the end user and the people that we really want to be educated." - Chelsea Ryckis
One of the most influential duos in healthcare, Chelsea and Donovan Ryckis, joined me this week to discuss their company Ethos Benefits, running a benefits agency based on values, and producing the documentary “It’s Not Personal, It’s Just Healthcare.”
Along the way, we get into each of their origins in insurance, how they met each other, and what it’s like to run an insurance agency with your spouse. Chelsea and Donovan also share why they’re so passionate about promoting transparency and accountability in this space.
Chapters:
00:00:00 Meet Chelsea & Donovan Ryckis
00:11:20 Getting Started In Health Insurance Consulting
00:18:08 Client-First Financial Advising
00:29:47 Building A Business Based On Values
00:35:32 Enhancing Client Value Through Self-Funding
00:37:33 Performance-Based Compensation
00:41:06 Value-Based Employee Retention
00:53:15 Compensation Transparency
00:59:08 Producing A Healthcare Documentary
01:07:49 Promoting Accountability 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:
Insurance Consulting, Fiduciary, Ethos, documentary, producing, filmmaking, movie, film, Client Retention, Employee Retention, Compensation Structure, Compensation, Transparency, Employee Benefits, fixing healthcare, podcast benefits, health, healthcare, health insurance, self funded, self funding
InsuranceConsulting #Fiduciary #Ethos #documentary #producing #filmmaking #movie #film #ClientRetention #CompensationStructure #EmployeeRetention #Compensation #Transparency #EmployeeBenefits #fixinghealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"I think I'd say our patients deserve better. Our Americans who are encountering the healthcare system deserve better." - Binu SamuelBinu Samuel, Director of Commercial Partnerships at Carrum Health, joined me for the first podcast of 2025 to discuss how we lower healthcare costs for self-funded employers. Binu, and Carrum’s, mission is to make healthcare easier for the employers, employees, and physicians, which includes focusing on making healthcare cost nothing out of pocket to employees. That also typically increases the amount of proactive care that members engage with, which is key to catching huge health problems before they happen.Join us this week to learn how to save money for employers and employees! Chapters:00:00:00 Meet Binu Samuel
00:04:42 Outcome-Driven Healthcare
00:05:12 Value-Based Care
00:10:55 Cost-saving Strategies For Employers
00:20:01 Enhanced Healthcare Cost Savings
00:25:51 Carrum's Mission
00:29:51 Predictive Member Care Outreach for Procedures
00:34:20 The Benefits Of Proactive Healthcare
Key Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: Value Based Care, Patient Experience, network, Employers, Cancer Treatment, Cost Savings, Proactive Care, Warranty System, Healthcare Innovation, Quality Care, Transparent Healthcare, fixing healthcare, podcast, benefits, health, healthcare, health insurance, self funded, self funding#ValueBasedCare #PatientExperience #network #Employers #CancerTreatment #CostSavings #ProactiveCare #WarrantySystem #HealthcareInnovation #QualityCare #TransparentHealthcare #fixinghealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"Everybody makes an excuse at the end as to why they didn't post or why they didn't start the thing they really wanted to start." - Me
Happy New Year! As a bonus episode this week, I’m sharing a talk I gave at a recent ParetoHealth event about getting started with social media content, and how it can be used effectively for sales.
Whether you’re new to the industry or you’ve been in it for decades, it’s never too late to start a social media presence, and I share some practical tips on how to get started.
Chapters:
00:00:00 Social Media Presence
00:01:43 Utilizing Social Media To Boost Sales
00:04:01 How To Build Your LinkedIn Network
00:07:32 How To Get Started With Video Content
00:14:00 How The Podcast Impacts My Industry Presence
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:
Social Media Sales, social media, linkedin, brandbuilding, Engagement, Podcasting, content, networking Content Creation, Authenticity, Consistency, Virtual Networking, podcast, benefits, health, healthcare, health insurance, self funded, self funding
SocialMediaSales #socialmedia #linkedin #brandbuilding #Engagement #Podcasting #content #networking #ContentCreation #Authenticity #Consistency #VirtualNetworking #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"They have to understand the value. That’s how you get people to use it." - Megan Glaros
“I had somebody who said once, why take a pill when you can get a shot? That's the way we kind of treat health, is like, just treat us with medication.” - Matt Glaros
For the final podcast of 2024, Matt and Megan Glaros joined me (in a different studio than usual!) to discuss the unique ways that they both approach benefits.
Matt helped grow his family’s agency before co-founding the Meyers Glaros Group, while Megan is a former meteorologist and TV personality who joined the insurance world recently to film benefits education content for employers, and she shares the fresh perspective she has as an industry outsider.
I’m obviously passionate about the role that content plays in broadening the understanding of the healthcare system in America, and we talked about the impact that their content has had so far, both on cost containment for employers and on individual employees lives.
Join us for a conversation on the power of educational content and how it can (help) solve some of this industry’s biggest challenges.
Chapters:
00:00:00 Meet Matt and Megan Glaros
00:03:08 Megan’s Experience As A Meteorologist
00:19:45 Why Megan Left The TV Industry
00:28:29 Engaging Insurance Education
00:36:05 How Do We Get Employees To Understand Their Benefits?
00:40:15 It’s Hard To Get Employees To Engage With Their Benefits
00:53:07 Empowering Employees
00:55:58 Cost-Effective Healthcare Education
01:08:39 Enhancing Cost Containment Through Employee Education
01:12:23 AI's Impact on Benefits
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:
Effective Communication, Communication, Meteorology, TV Industry, Employee Benefits, Storytelling, AI, AI Healthcare, healthcare tech, health tech, Employer, Education, Care Navigation, podcast, benefits, health, healthcare, health insurance, self funded, self funding
EffectiveCommunication #Communication #Meteorology #TVIndustry #EmployeeBenefits #Storytelling #AI #AIHealthcare #healthcaretech #healthtech #Employer #Education #CareNavigation #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"I felt like I was putting $10,000 bandaids on someone's diabetic ketoacidosis instead of actually helping them to never be there in the first place." - Tiffany Ryder
Tiffany Ryder, medical physician associate and healthcare advocate, joined me this week to continue the theme of my previous episode: how do we empower patients to make informed decisions, and to advocate for a better system?
Tiffany shared with me her journey to this space, which took her from the world of NFL cheerleading to providing care as a medical physician associate, and why that gives her a unique perspective on the industry.
We talk about the critical lack of awareness that the average American has of how the healthcare and health insurance industries work, why there needs to be much more transparency in these spaces, and what the future looks like for healthcare in America.
Chapters:
00:00:00 Meet Tiffany Ryder
00:00:38 Veterans' Healthcare
00:24:39 Empowering Patients
00:29:08 Healthcare Cost Transparency
00:37:50 Informed Decision-Making in Healthcare
00:40:33 Simplifying Healthcare Communication
00:45:12 Ethical Dilemmas in Healthcare
00:54:23 Advocating For A Better System
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:
Impact, Patient Advocacy, advocacy, Transparency, Patient Care, education, Effective Communication, fair, provider, Ethical Healthcare, Healthcare Awareness, Veterans Healthcare, Patient Empowerment, affordable healthcare, podcast, benefits, health, healthcare, health insurance, self funded, self funding
Impact #PatientAdvocacy #advocacy #Transparency #PatientCare #education #EffectiveCommunication #fair #provider #EthicalHealthcare #HealthcareAwareness #VeteransHealthcare #PatientEmpowerment #affordablehealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"I think that the general public thinks that health care is just expensive and this is just the way it has to be. It doesn't. And I think if more people knew that they would rise up and fight the system, fight for change.” - Jenni Nolan
Jenni Nolan, Board-Certified Patient Advocate at Clear Healthcare Advocacy, joined me this week to discuss the need for more patient advocacy in America, and how she goes about negotiating medical bills with hospitals, on the behalf of patients.
The number one thing we need in this industry as a whole is more consumer education. As Jenni shares, many people will get a huge hospital bill and assume that the only option they have is to go into a huge amount of debt.
The emergence of patient advocates has helped so many across the country get their bills corrected/lowered, and Jenni and I discussed the sector as a whole and what the future looks like for medical billing in this country.
Chapters:
00:00:00 Meet Jenni Nolan
00:03:23 Advocating For Patients
00:10:01 Correcting Healthcare Billing Mistakes
00:15:39 Understanding Medical Billing
00:23:05 Healthcare Costs' Long-Term Financial Impact
00:29:36 Negotiating Fair Hospital Bills
00:32:09 Fair Hospital Billing Rate Negotiations
00:48:11 Navigating Healthcare As A Consumer
00:53:41 Empowering Individuals through Healthcare Education
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:
Patient Advocacy, Medical Billing, advocate, advocacy, Billing, errors, Hospital Bills, medical bills, Transparency, affordable healthcare, Patient Advocates, Healthcare Literacy, Hospital Billing, Education, Fair Healthcare, podcast, benefits, health, healthcare, health insurance, self funded, self funding
PatientAdvocacy #MedicalBilling #advocate #advocacy #Billing #errors #HospitalBills #medicalbills #Transparency #affordablehealthcare #PatientAdvocates #HealthcareLiteracy #HospitalBilling #Education #FairHealthcare #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"Any time you can reward employees for doing the right thing, to me, it's benefiting the employer group, it’s benefitting everybody.” - David Mallen
You can provide employees with the best healthcare benefits in the world, but if they don’t know how to navigate the healthcare system, those benefits aren’t very effective.
David Mallen, EVP of Partnerships at HealthJoy, joined me this week in studio to discuss care navigation and how we make benefits plans more effective for employees.
Having personally used Healthjoy, I think there’s immense value in a care navigation solution like this; we need to empower healthcare consumers to understand that they can often get the same/better care for cheaper, both to them and the health plan.
Chapters:
00:00:00 Meet David Mallen
00:04:42 From Baseball to Healthcare
00:07:28 Healthcare Advocacy
00:18:56 Personalized Healthcare Navigation
00:21:34 Streamlining Healthcare Benefits
00:23:45 Personalized Patient Care
00:36:03 Enhanced Healthcare Interactions For Patients
00:41:54 Healthcare Experiences That Are Backed By Data
00:47:23 Empowering Consumers To Make Decisions
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:
HealthJoy, Healthcare Tech, Care Navigation, Digital Healthcare, virtual care, Wellness, wellness programs, baseball, advocacy, advocate, Healthcare Integration, FitnessJourney, Telemedicine, Member Experience, Future Healthcare, Preventive Health, podcast, benefits, health, healthcare, health insurance, self funded, self funding
HealthJoy #HealthcareTech #CareNavigation #DigitalHealthcare #virtualcare #Wellness #wellnessprograms #baseball #advocacy #advocate #HealthcareIntegration #FitnessJourney #Telemedicine #MemberExperience #FutureHealthcare #PreventiveHealth #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding
"Looking back now, cancer gave me something to fight for at a time when I felt like maybe life wasn't worth fighting for." - Dylan Slattery
Dylan Slattery, VP at ClaimsBridge and motivational speaker at Stage Four 2 On Stage, joined me this week to share his powerful story of beating stage four cancer against all odds, beating it again when it recurred, and how that experience completely changed his perspective on life and healthcare.
Dylan was diagnosed with stage 4 melanoma completely out of nowhere at the age of 23. We discussed the traditional treatment plan that he initially followed, and the somewhat experimental immunotherapy treatment that actually worked.
We also discussed the impact that diagnosis had on his family, his friends, and him, what kept him fighting in his darkest moments, and why he wants to continue to share his story to inspire others.
Chapters:
00:00:00 Meet Dylan Slattery
00:11:33 Stage Four Melanoma Diagnosis
00:19:47 Dylan’s Healthcare Journey
00:27:21 Why Immunotherapy Worked For Dylan
00:38:07 Melanoma Reoccurrence and Recovery
00:48:24 Simplifying Healthcare Communication
00:53:29 Enhancing Employee Well-being Through Healthcare
00:55:56 The Financial Barriers in Accessing Healthcare Services
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:
melanoma, terminal, immunotherapy, cancer survivorship, healthcare journey, healthcare costs, cancer awareness wellness management, patient advocacy, survivor, cancer, stage four, stage 4, podcast, health, healthcare, health insurance, self funded, self funding
melanoma #terminal #immunotherapy #cancersurvivorship #healthcarejourney #healthcarecosts #cancerawareness #wellnessmanagement #patientadvocacy #survivor #cancer #stagefour #stage4 #podcast #health #healthcare #healthinsurance #selffunded #selffunding
“I’m going to say something that people claim isn’t true, but it is. I’m an ear nose and throat doctor. I don't remember your eardrum from last year. I don't care what people tell you, doctors don't remember 3,000 eardrums.” - Danish Nagda
Danish Nagda, founder of Rezilient, has come up with a pretty unique solution to doctor burnout in primary care: a hybrid model, where patients go in-person to checkups, an attendant takes all of their vital signs, and the data is uploaded directly to a doctor.
As an ear, nose, and throat doctor himself, Danish understands the importance of the human touch in healthcare, but also sees the future of primary care as data-based: for instance, if a doctor has your exact EKG readings from a year ago, they have a baseline to measure your current data off of.
Rezilient haș also focused on making all of this appealing to employers, and he shares why this model has positive ROI within the first year for most.
Join us this week as we explore the future of primary care!
Chapters:
00:00:00 Meet Danish Nagda
00:01:02 The Future Of GLP-1s
00:06:19 Comprehensive Healthcare Access
00:09:58 Physician Burnout
00:14:04 Healthcare Should Focus On Data
00:17:54 Tech-Focused Primary Care
00:26:24 The Importance Of The Primary Care Doctor
00:47:05 The ROI Of Rezilient For Employers
00:51:09 Empowering Patients Through Accessible Healthcare Data
01:01:42 The Future Of Rezilient
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:
Obesity Drugs, GLP1s, GLPs, Physician Mental Health, Rezilient, Concierge Medicine, Tech Enabled Care, Healthcare Transparency, Healthcare AI, Healthcare Innovation, Virtual Care Model, virtual care, podcast, primary care, doctor, health, healthcare, health insurance, self funded, self funding
ObesityDrugs #GLP1s #GLPs #PhysicianMentalHealth #Rezilient #ConciergeMedicine #TechEnabledCare #HealthcareTransparency #HealthcareAI #HealthcareInnovation #VirtualCareModel #virtualcare #podcast #primarycare #doctor #health #healthcare #healthinsurance #selffunded #selffunding
"In what other industry could a purveyor put out 99% bad bills and stay in business?" - Linda Komisak
“They're diagnosing things for things that you don't even have. And that’s scary.” - Kimberly Carleson
Kimberly Carleson, CEO of US Beacon, and Linda Komisak, founder of Upturn Consulting LLC, joined me to talk about two critical ways of increasing healthcare transparency: claims reviews and quality metrics.
These two topics are key to understanding why the healthcare system is so broken. If you buy any other service, you can (a) expect to only be billed for the services that were performed and (b) have the ability to research the quality of vendors and pick the best one.
Why can’t we do that in healthcare?
This is an incredibly informative episode, and we cover more than just those two topics including nurse staffing shortages, how to identify the best hospital systems, and why it’s so important to gather feedback from nurses.
Chapters:
00:00:00 Meet Kimberly Carleson and Linda Komisak
00:01:11 Taking Feedback from Nurses
00:06:30 Nurses' Impact on Hospital Quality
00:11:31 Why Are There Nursing Shortages?
00:18:18 Nurse Advocacy for Enhanced Patient Experience
00:25:18 Quality Metrics and Patient Billing Integrity
00:39:11 The Importance of Nurse Feedback
00:49:17 Surgeon Incentives in Billing
00:58:12 Healthcare Cost Savings Through Billing Review
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 Quality, Nurse Insights, Patient Experience, Claims Integrity, Quality Metrics, Upcoding Practices, Nursing Shortage, Billing Transparency, Nurse Anonymity, Healthcare Billing, Hospital Quality, Nurse Feedback, insurance, nursing, healthcare, health insurance, podcast, self funded, self funding
HealthcareQuality #NurseInsights #PatientExperience #ClaimsIntegrity #QualityMetrics #UpcodingPractices #NursingShortage #BillingTransparency #NurseAnonymity #HealthcareBilling #HospitalQuality #NurseFeedback #insurance #nursing #healthcare #healthinsurance #podcast #selffunded #selffunding
"Quit tolerating mediocrity. Go get in action. Find the right broker consultant that will take you to a new place. Don't give up hope." - Scott Conard
Dr. Scott Conard tragically lost 3 patients one summer to unexpected heart problems, and immediately changed how he thought of healthcare.
This week on Self-Funded, we talk about “conscious capitalism”, and by extension “conscious healthcare”, what the 7 numbers that everybody needs to know are, and how we need to change the way we approach health risk.
Chapters:
00:00:00 Meet Scott Conard
00:02:08 Crony Capitalism In Healthcare
00:06:34 Focus On Aligning Incentives
00:15:38 Holistic Well-being Approach To Healthcare
00:27:12 Revolutionizing Self-Insurance
00:37:54 Healthcare Advocacy And Engagement
00:42:22 How Do We Get People To Care About Their Health?
00:49:08 Primary Care's Role 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:
Conscious Capitalism, Employer Driven Healthcare, insurance, healthcare, health insurance, Empowering Employers, Incentive Programs, Risk Management, Alternative Risk, health risk, fixing healthcare, selffunded, podcast
ConsciousCapitalism #EmployerDrivenHealthcare #insurance #healthcare #healthinsurance #EmpoweringEmployers #IncentivePrograms #RiskManagement #AlternativeRisk #healthrisk #fixinghealthcare #selffunded #podcast
"It's progress we couldn't have envisioned decades ago." - Oscar
“I felt interested in being part of something bigger than my practice and something that will impact even more people that I was able to in the hospital.” - Carolina
Dr. Oscar Bronsther and Dr. Carolina Escobar from Interlink joined me this week to discuss the exciting and scary world of cell and gene therapy, CRISPR, and how we fund these amazing medical advances.
In addition to me attempting to act smart enough to be in the same room as these two, we covered their wholistic approach to this emerging scientific field, which promises potential cures for rare and debilitating diseases, but often comes with 7-figure price tags. The rare genetic diseases are known as “orphan diseases”, and there have been some recent incredible advances in detecting them early on in life.
We talked about what this all means for individuals as well as the insurance space as a whole, and how it has the potential to increase medical costs in this country even further.
Chapters:
00:00:00 Meet Oscar and Carolina
00:09:16 Genetic Therapy Solutions for Orphan Diseases
00:14:39 Detecting and Targeting Single Gene Mutations
00:26:52 CRISPR Technology
00:30:08 Equitable Access To Gene/Cell Therapy
00:37:21 How Do We Finance This?
00:46:13 The Ethical Concerns Of Cell/Gene Therapy
00:59:45 Economic Implications of This Technology
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:
Rare Diseases, Gene Therapy, CRISPR technology, CRISPR, Healthcare Skepticism, Healthcare Warranties, Medical Revolution, Healthcare Advances, Orphan Diseases, Cell Therapy, Healthcare Innovation, self funded, podcast
RareDiseases #GeneTherapy #CRISPRtechnology #CRISPR #HealthcareSkepticism #HealthcareWarranties #MedicalRevolution #HealthcareAdvances #OrphanDiseases #CellTherapy #HealthcareInnovation #selffunded #podcast
"If my child needs a gene therapy to live, they should get it and anyone's child should. So let's figure out how to pay for it." - Jake Frenz
On the final of four podcasts filmed at a recent healthcare thinktank I hosted in Frisco, Texas, Jake Frenz, the founder and CEO of SmithRx, joined me to share his journey from the Marine Corps to Pharmacy Benefit Management, and what makes him so passionate about ending prescription drug price gouging.
Jake and I discussed what some of the core challenges are in the PBM space, why he was so inspired by Mark Cuban’s venture Cost Plus Drugs, and what the “watershed” moment in US healthcare will look like.
I’m grateful to have had the opportunity to talk to one of the best minds in the PBM space, and I hope you enjoy this week’s episode of Self-Funded with Spencer.
Chapters:
00:00:00 Meet Jake Frenz
00:08:06 Consumer-Driven Healthcare
00:15:53 Transparency in the PBM Industry
00:20:57 The “Watershed Moment” in US Healthcare
00:36:14 Mark Cuban's Innovative Healthcare Venture
00:39:34 Subscription-Based Models Disrupting Pharmacy Competition
00:52:34 Revolutionizing Healthcare
00:55:14 Empowering Americans to Drive Healthcare Reform
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 Insights, Pharmacy Benefit Managersm, Simplify Healthcare, Watershed Moment, Cost Plus, cost plus drugs, mark cuban, Big Picture Healthcare, American Spirit, Healthcare Innovation, Affordable Medications, price gouging, self funded, podcast
HealthcareInsights #PharmacyBenefitManagers #SimplifyHealthcare #WatershedMoment #CostPlus #costplusdrugs #markcuban #BigPictureHealthcare #AmericanSpirit #HealthcareInnovation #AffordableMedications #pricegouging #selffunded #podcast
"I would say a lot of it is education, helping both the member and the provider realize that it's okay for them to get healthcare in home." - Dan Cochran
On the third of four podcasts filmed at a recent healthcare thinktank I hosted in Frisco, Texas, Dan Cochran, CEO of Cochran Health Ventures, joined me to discuss infusions, in-home healthcare, why the future of healthcare will be personalized, and how we educate consumers.
I, and many others in this industry, consistently advocate that much of healthcare is way too complex for the average consumer and that they don’t know how to utilize the solutions when they are available. Dan and I discussed that problem, ways that people can educate themselves, and how we can push for more healthcare education in America.
Chapters:
00:00:00 Meet Dan Cochran
00:09:58 The Future Of Self-Insurance for Employers
00:12:09 The Payer-Provider Dynamic
00:19:19 How Do Consumers Navigate Healthcare?
00:28:29 Sustainable Business Success By Focusing On Clients
00:36:12 We Can Fix Healthcare By Focusing On Patients
00:42:01 Healthcare Cost-Saving Strategies
00:45:34 Empowering Consumers Through Healthcare Education
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:
Self Insurance, Cost Management, Healthcare Solutions, Client Retention, Consumer Education, Healthcare Complexity, Care Appropriateness, Plan Design, Payer Insights, Infusion, Home Infusion, Remote Specialty Care, Future Healthcare, Healthcare, Insurance, self funded, podcast
SelfInsurance #CostManagement #HealthcareSolutions #ClientRetention #ConsumerEducation #HealthcareComplexity #CareAppropriateness #PlanDesign #PayerInsights #Infusion #HomeInfusion #RemoteSpecialtyCare #FutureHealthcare #Healthcare #Insurance #selffunded #podcast
"There can be a better path forward. We don't have to remain adherent to the system that is built against us. It's just going to take some rolling up of the sleeves and a commitment to it." - Shawn Sanford
This week, another ParetoHealth colleague joins the show: Shawn Sanford, RVP of Sales and Pod Leader.
Shawn and I discussed his transition from pro baseball to ancillary benefit sales to Pareto, and what he learned from each step along the way.
We also discuss some of the biggest problems in this industry and why they excite Shawn so much, and what he sees as the single biggest case of “highway robbery” in healthcare.
Join us this week on Self-Funded as we discuss the opportunity we have to fix healthcare.
Chapters:
00:00:00 Meet Shawn Sanford
00:14:02 An Unexpected Career Transition Into Insurance
00:22:43 The Importance Of Networking In Sales
00:25:48 Building Trust With Brokers
00:31:39 Transition to ParetoHealth
00:42:25 Having The Right Sales Process
00:51:49 Equity and Transparency in Healthcare
00:55:54 Aligning Incentives Properly
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:
Sales Success, Career Transition, Relationship Building, Healthcare Reforms, Insurance Industry, Education Matters, Sales Process, Healthcare Awareness, Healthcare Challenges, Healthcare Transformation, Sales Networking, Career Advancement, self funded, podcast
SalesSuccess #CareerTransition #RelationshipBuilding #HealthcareReforms #InsuranceIndustry #EducationMatters #SalesProcess #HealthcareAwareness #HealthcareChallenges #HealthcareTransformation #SalesNetworking #CareerAdvancement #selffunded #podcast
“There's a reason why every insurance carrier likely owns or is owned by a pharmacy benefit management company, that’s one of the ways that they can drive revenue." - Kristen Rivers
My guest this week, Kristen Rivers from ParetoHealth, is one of the strongest healthcare advocates I know.
This week on Self-Funded, Kristen and I discuss her upbringing, how that affects the work she does today, what caused her to leave a position at the biggest insurance company in the world, and why she believes in the work she’s doing at ParetoHealth today.
Along the way, we talk about some of the biggest problems in healthcare, from the user experience to misaligned incentives that profit from driving up the cost of healthcare.
The main takeaway: we need more advocates like Kristen if we’re going to fix this industry.
Chapters:
00:00:00 Introducing Kristen Rivers
00:08:16 Kristen’s Introduction To Health Insurance
00:16:10 The Importance of Data Transparency and Choice
00:19:50 Advocating For Better Healthcare
00:33:23 Renewal Increases in California Insurance Market
00:35:18 Medicare Cuts
00:41:18 Employer-led Healthcare Plans
00:51:06 Misaligned Incentives
00:53:26 Driving Down Healthcare Costs through Employer Advocacy
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 Industry Transition, Transparency Matters, Navigating Healthcare, California Insurance Market, Medicare Cuts, Self Funded Plans Healthcare Quality Metrics Industry Complexities, Employer Advocacy, CAA Regulations, Healthcare System, Cost Management, self funded, podcast
HealthcareIndustryTransition #TransparencyMatters #NavigatingHealthcare #CaliforniaInsuranceMarket #MedicareCuts #SelfFundedPlans #HealthcareQualityMetrics #IndustryComplexities #EmployerAdvocacy #CAARegulations #HealthcareSystem #CostManagement #selffunded #podcast
Luke Aslesen, founder of INFRMD, joined me a few weeks ago for the podcast, and we also filmed this extended interview after, in which Luke asks me about my comedy background, upbringing, relationship with my wife, and more.
If you’re a long-time listener of the podcast and want to get to know me a bit better, or you just stumbled onto the podcast and want to know who I am, this is a great place to start!
Chapters:
00:00:00 Luke/Spencer Q+A
00:00:35 When/how did you think of bringing your entertainment background into insurance?
00:01:35 What’s the biggest thing you’ve taken from stand-up in the work you do today?
00:02:37 How did your upbringing affect the work that you do now?
00:03:36 How do you not burn out with all the work you do?
00:05:03 How do you balance doing both creative and logical work?
00:06:33 How do you keep yourself accountable?
00:08:57 Have you already seen the rewards of the work you’re putting in, or is that down the road?
00:10:57 What does “justice” mean in the work that you do?
00:12:31 How do you keep the hope alive?
00:13:54 What do you do to keep yourself motivated?
00:15:20 Where do you find the time to do all of those things?
00:16:41 Where did Tom Broker come from?
00:18:21 Favorite comic of all time?
00:19:57 What has the response been to using comedy?
00:22:03 Does using comedy open doors for you?
00:24:29 Why don’t more people build personal brands?
00:26:30 Where did your love for people come from?
00:27:42 If you could have a 4-hour dinner with anybody, who would it be and why?
00:28:46 How has your relationship with your wife shaped your success?
00:35:53 When you’re retired, how do you want to be remembered?
00:36:44 Tell us about your car.
00:39:08 Favorite comedy movie and series?
00:41:05 Favorite drama movie and series?
00:42:41 If you could have one message on a billboard that everyone could see, what would it be?
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:
QA #spencersmith #infrmd #insurance #entertainment #standup #creativity #justice #accountability #comedy #celsius #joerogan #mustangs #selffunded #selffunding #podcast
QA, spencer smith, infrmd, insurance, entertainment, standup, creativity, justice, accountability, comedy, celsius joe rogan, mustangs self funded, self funding, podcast
“PBM is one of the most complicated concepts out there and it's incredibly difficult to understand. But it's not because the system itself is complicated. It's because pbms make it complicated.” - Justin Jasniewski
Justin Jasniewski, CEO of Serve You Rx, joined me this week to discuss the state of the pharmacy benefit management (PBM) market in 2024.
We discussed the competitive landscape in the PBM industry, why that’s (slowly) leading to more actual transparency, and how Serve You Rx fits into that market.
Justin and I also discussed GLP-1s, how they’re going to continue to be a problem for the industry to solve for, and what they say about the effectiveness of wellness initiatives.
Chapters:
00:00:00 Introducing Justin Jasniewski
00:03:01 The PBM Market in 2024
00:06:28 Tailoring PBM Solutions
00:17:59 How Do GLP-1s Affect The PBM Industry?
00:26:37 Real Transparency In PBMs
00:32:39 The Importance Of Customer Service For PBMs
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:
PBM Landscape, PBM Flexibility, Self Insurance Simplified, GLP1s, Future Of PBMs, Service Quality PBM, Client Satisfaction, Regulatory Changes, Transparent Pricing, Rebate Handling, Emerging Solutions, self funded, podcast
PBMLandscape #PBMFlexibility #SelfInsuranceSimplified #GLP1s #FutureOfPBMs #ServiceQualityPBM #ClientSatisfaction #RegulatoryChanges #TransparentPricing #RebateHandling #EmergingSolutions #selffunded #podcast
“You know, Africa has no peanut allergies.” - Dr. Marty Makary
I was honored to be joined this week by Dr. Marty Makary to promote his new book “Blind Spots”, which published this week and is currently a national bestseller.
To purchase “Blind Spots”, use this link: https://geni.us/blindspots
Dr. Marty Makary is a surgeon, researcher, and author, as well as an advocate for better approaches to public health. He’s known for challenging medical dogma and asking the questions nobody else will. In our conversation, we talked about his new book, why these misguided public health recommendations get broadcast in the first place, and why it’s so important to have better health conversations in this country.
One of the bigger topics that we covered was the peanut allergy epidemic, and why Marty Makary believes that recommendations based on opinion instead of data caused so many more kids to get peanut allergies than they would otherwise.
Chapters:
00:00:00 Introducing Dr. Marty Makary
00:08:13 Misguided Public Medical Recommendations
00:14:49 Challenging Established Health Norms
00:24:46 Why The Low-Fat Diet Was Misinformation
00:36:45 Why Are We Doing So Many C-Sections?
00:41:46 Unnecessary Medical Care
00:47:56 Questioning Medical Dogma
00:50:11 Influential Figures Shaping Health Conversations
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:
Blind Spots, Medical Dogma, Evidence Based Medicine, Public Health, Nutrition Misinformation, C-Section Consequences, Healthcare Challenges, Health Awareness, Public Health Figures, Critical Thinking, Health Discourse, Quality Healthcare, self funded, podcast, peanut allergies, peanut allergy, peanut allergy epidemic, marty makary, dr marty makary, pediatricions, public health recommendations
BlindSpots #MedicalDogma #EvidenceBasedMedicine #PublicHealth #NutritionMisinformation #CSectionConsequences #HealthcareChallenges #HealthAwareness #PublicHealthFigures #CriticalThinking #HealthDiscourse #QualityHealthcare #selffunded #podcast
“So many times these employers are like, ‘dude, I spend so much money on this, and my employees don't care at all.’ Or what's even worse is they go, ‘our employees love it, we have a great, great plan.’ Did they tell you that?” - Luke Aslesen
This is one of my favorite podcasts of the year: Luke Aslesen, Founder of INFRMD, joined me to talk about entrepreneurship, creativity in insurance, comedy, and how to stay authentic.
INFRMD is an insurance education platform, designed to make it as easy as possible for employees to understand and use their benefits. Luke and I discussed the importance of education, why this type of solution is so needed, and how he value it provides to employers.
This podcast is a bit longer than usual, but only because I think this conversation truly justified that. Join me and Luke this week on Self-Funded to learn how to stay creative and authentic in this industry!
Chapters:
00:00:00 Introducing Luke Aslesen
00:00:35 Timing and Persistence in Entrepreneurship
00:07:42 Embracing Imperfection
00:10:56 A Creative Approach to Insurance Education
00:21:29 How Do You Teach People To Navigate Healthcare?
00:32:09 The Importance Of Creativity
00:46:11 Humor In The Insurance Industry
00:49:12 Revolutionizing Insurance Literacy with INFRMD
01:05:06 Empowering Informed Decision-Making
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:
Entrepreneurship #StartingBeforePerfect #InsuranceEngagement #GenerationalShift #ConsumerEmpowerment #InformingConsumer #CareerCreativity #InsuranceCommunity #HumorInCommunity #HealthcareLiteracy #selffunded #selffunding #podcast
Entrepreneurship, Starting Before Perfect, Insurance Engagement, Generational Shift, Consumer Empowerment, Informing Consumer, Career Creativity, Insurance Community, Humor In Community, Healthcare Literacy, self funded, self funding, podcast
“If we're facing a [mental health] crisis and we want radical change, we’ve got to think about radical solutions. If those radical solutions can show objectively with safety and efficacy data, that they're really helping people and really changing lives, then I think we ought to at least explore and get curious about offering those solutions to to people.” - Amil Patel
We have a mental health crisis in America, and we need new solutions to help those who are struggling.
Amil Patel, from Meeko Health, joined the show this week to talk about offering ketamine therapies through the employee benefits channel.
I would suspect that many of you who listen to the podcast would be immediately skeptical about the effectiveness, safety, and utility of psychedelic therapy; honestly, going into the podcast, I was too.
But I would urge you to hear Amil’s testimony, look into the research and studies currently going on, and form your own opinion. And as Amil shares, hear the testimony of the many people who feel like they would still be in a mental health crisis without these therapies.
Join us this week on Self-Funded as we discuss why employers should consider offering psychedelic therapy as an employee benefit!
Check out their website - https://www.meekohealth.com/
Chapters:
00:00:00 Introducing Amil Patel00:03:30 Struggling With Parental Judgment00:12:58 The Mental Health Impact of Childhood Experiences00:18:16 Psychedelic Therapy Access Through Meeko 00:33:37 How Can We Prove That Psychedelic Therapy Works?00:43:37 Do Employers Want To Offer Ketamine Therapy To Employees?01:01:08 The Transformational Effect Of Ketamine Therapy01:03:58 Getting To The Root Of Mental Health Issues
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 #PsychedelicTherapy #MentalHealthCare #KetamineTherapy #PsychologicalApproach #CulturalImpact #HealingJourney #PersonalGrowth #PsychedelicSupport #MeekoHealth #selffunded #selffunding #podcast
Mental Health, Psychedelic Therapy, Mental Health Care, Ketamine Therapy, Psychological Approach, Cultural Impact, Healing Journey, Personal Growth, Psychedelic Support, Meeko Health, self funded, self funding, podcast
“Utilization is key for virtual urgent care. Let us be your first line of defense, rather than like, ‘oh, I do have a telemedicine on the back of my insurance card, I’m not sure what it does.’” - Jon O’Toole
Especially in the last few years (for obvious reasons), telehealth and virtual care have proved that they’re here to stay. But how do we best determine when a patient should use virtual or in-person care, and how do we actually get them to utilize it?
Jon O’Toole, from Recuro Health, joined me this week to share his take.
The benefits of virtual care are pretty clear: quicker access to appointments for patients at a much lower cost. As Jon shares, it’s extremely important to educate patients on their virtual benefits and to make the experience easy and tailored for them. Jon also speaks about virtual urgent care, which can add a ton of value and help alleviate some of the panic that sets in when a health emergency occurs.
Join us this week for a deep dive into virtual care and its future.
Chapters:
00:00:00 Introducing Jon O’Toole
00:14:37 Customizing Telehealth
00:17:09 Why We Need To Monitor Utilization
00:25:50 What Is “Virtual Urgent Care”?
00:31:00 Virtual Talk Therapy and Psychiatry
00:40:59 Using Data To Improve Benefits
00:42:04 AI-Enhanced Virtual 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:
TelehealthUtilization #ValueCreation #RemoteHealthcareMonitoring #VirtualUrgentCare #BehavioralHealth #UtilizationMonitoring #HealthcareEvolution #VirtualCare #InnovationInHealthcare #AIinHealthcare #Wearables #HealthTech #selffunded #podcast
Telehealth Utilization, Value Creation, Remote Healthcare Monitoring, Virtual Urgent Care, Behavioral Health, Utilization Monitoring, Healthcare Evolution, Virtual Care, Innovation In Healthcare, AI in Healthcare, Wearables, Health Tech, self funded, podcast
“Life is short. In the meantime, your health is, at the end of the day, your health is all you have." - Heather Bowers
Differentiating yourself through customer service is a tricky thing: it’s talked about so frequently that it can almost feel outdated focusing so much on the customer experience.
But, as my guest Heather Bowers from Lone Star Benefits shared with me this week, it’s still the best way to truly serve your clients in 2024.
Heather joined me from literally across the street, and we discussed what it’s like to be a business in Frisco, Texas, a rapidly growing city. Heather and I also discussed what it was like to take over the family business, as Lone Star was actually started by her father.
We also discussed how the industry has changed since she took over the business, dealing with compliance, and what future regulation may mean for healthcare.
Chapters:
00:00:00 Introducing Heather Bowers
00:12:09 Preserving The Family Business
00:16:18 Differentiating Through ACTUAL Customer Service
00:29:14 Taking Care Of Your Work, Family, and Personal Health
00:34:48 How Do We Get Members To Care About Health?
00:37:47 $10,000 Wellness Prize
00:40:13 Balancing GLP-1 Drugs with Lifestyle Changes
00:46:19 Navigating Compliance
00:53:39 Balancing Health and Passion in Business
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:
InsuranceIndustry #ClientRelationships #FriscoTexas #WorkLifeBalance #WellnessPrograms #EmployeeIncentives #WeightLoss #ComplianceRegulations #IndustrySolutions #PassionForWork #LongTermClients #SelfFunded #podcast
Insurance Industry, Client Relationships, Frisco Texas, Work Life Balance, Wellness Programs, Employee Incentives, Weight Loss, Compliance Regulations, Industry Solutions. Passion For Work, Long Term Clients, Self Funded, podcast
“We're simplifying the complexities of healthcare. We gotta declutter it, we've gotta demystify it, we've gotta make it more transparent and understandable in bite sized ways where members know and understand what's happening for and to them." - Rob Gelb
It sounds like a simple question, but as an industry, we’re still working towards figuring it out: how do we engage members?
Rob Gelb joined me this week to discuss what role Valenz has in solving that seemingly unsolvable equation.
Along the way, Rob and I also discuss his perspective on sales, why “yes, and,” is so important in Valenz’s culture, and where the healthcare industry is moving towards, big picture.
Chapters:
00:00:00 Introducing Rob Gelb
00:06:23 Sales Is Just Solving Problems
00:13:07 Creating Cohesive Health Plans
00:22:32 How Do We Engage Members?
00:30:52 'Yes, and'
00:42:00 Valenz’s Role In The Marketplace
01:03:31 The Role Of Private Equity In This Industry
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:
SalesSuccess #HealthPlanInnovation #HealthcareLiteracy #BrandPromise #CulturalTransformation #ValenzHealthcare #HealthcareTransparency #ReferenceBasedPricing #PrivateEquityHealthcare #BusinessGrowth #CompetitionInHealthcare #StimulatingThoughts #SelfFunded #podcast
Sales Success, Health Plan Innovation, Healthcare Literacy, Brand Promise, Cultural Transformation, Valenz Healthcare, Healthcare Transparency, Reference Based Pricing, Private Equity Healthcare, Business Growth, Competition In Healthcare, Stimulating Thoughts, Self Funded, podcast
“If you talk to almost anyone in this industry over a beer or something like that, I think they will all agree that we are operating in a pretty antiquated industry that needs some serious modernization, innovation, reimagination." - Brandon Weber
This week’s episode of Self-Funded is coming to you from the (unfinished) San Francisco ParetoHealth office.
Brandon Weber, founder of Nava Benefits, joined the healthcare industry as an outsider: he’s spent most of his career as a tech entrepreneur, and after exiting his previous company, he found himself with a lot of free time and a lot of unfocused energy.
Brandon actually chose healthcare as the next industry he wanted to take on while he was spending a year long sabbatical with his wife, traveling the world, and realized that healthcare was such a huge societal problem that needed to be solved. So, he founded Nava Benefits.
On this week’s episode, we discussed what his unique perspective has led him to believe about the healthcare industry, how healthcare operates throughout the world, the importance of brokers, the necessity of competition in any industry, and why Nava is a great step towards fixing healthcare in this country.
Chapters:
00:00:00 Introducing Brandon Weber
00:11:50 Why Brokers Are So Important
00:19:55 Why Are Benefits Plans So Complex?
00:22:42 Rising Costs in Healthcare
00:26:12 Simplifying Healthcare Access
00:40:10 Nava’s Focus On Efficiency
00:53:28 Fixing Healthcare Now
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:
BenefitsManagement #HealthcareChallenges #TechnologyInBenefits #CareNavigation #ClientService #OperationalEfficiency #ServiceAutomation #AmericanHealthcare #ModernizingHealthcare #BenefitsConsultants #HealthcareInnovation #EmployeeBenefits #selffunded #podcast
Benefits Management, Healthcare Challenges, Technology In Benefits, Care Navigation, Client Service, Operational Efficiency, Service Automation, American Healthcare, Modernizing Healthcare, Benefits Consultants, Healthcare Innovation, Employee Benefits, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"I think, not just in terms of the type of AI Verikai does, but AI in healthcare in general, I'm so optimistic about it, just because we are in such early stages of this." - Justen Nestico
Did you know that what type of car you drive determines how healthy you're likely to be?
Justen Nestico, Director of Actuarial Solutions at Verikai, joined me this week to discuss a really important thing when it comes to risk assessment: data.
We talked about how Verikai integrating AI in interpreting, organizing, and learning from data, as well as what that data says about a populace and how to insure them. Justen and I also covered GLP-1s, like Ozempic, and what they potentially mean for reducing health risks related to obesity.
Justen shared with me the five social determinants of health he sees most often, and some of them were pretty surprising, like what type of car you drive.
Join us this week to learn all about AI, risk, and what determines health!
Chapters:
(00:00:00) Introducing Justen Nestico
(00:08:08) Risk Assessment In Self-Funding
(00:10:27) Utilizing AI In Risk Assessment
(00:14:47) Consumer Insights from Credit Card Transactions
(00:21:18) GLP-1s
(00:31:17) The Social Determinants Of Health
(00:40:03) Impact of Lifestyle Choices on Health
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:
AIHealthcare #RiskAssessment #DataAnalysis #HealthcareInnovation #BehavioralHealth #LifestyleModification #FinancialIncentives #MachineLearning #HealthcareInequalities #FutureHealthcare #RiskScoring #SelfFunding #selffunded #podcast
AI Healthcare, Risk Assessment, Data Analysis, Healthcare Innovation, Behavioral Health, Lifestyle Modification, Financial Incentives, Machine Learning, Healthcare Inequalities, Future Healthcare, Risk Scoring, Self Funding, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"The best way I can explain it is the concept is like your house is on fire, and now you go get homeowners insurance." - Kevin Chambers
Kevin Chambers (Lucent Health) joined me this week to help me understand just what makes tribal healthcare plans so unique.
As Kevin shares in this episode, many companies are somewhat scared to insure tribes, as they have sovereignty and so any potential lawsuits are tried in tribal court. That doesn’t mean that this niche needs to be neglected, though; tribes actually have some huge opportunities to build really effective healthcare plans.
Kevin and I discussed the federal government’s role in tribal healthcare, and the four main “pillars” he uses to insure tribes; four little-known government sponsored entitlements that subsidize tribal healthcare, including the ability for native people to pay Medicare rates for their healthcare, which Kevin calls “the ultimate Reference-Based Pricing”.
Tune in this week for a look into the world of tribal healthcare!
Chapters:
(00:00:00) Introducing Kevin Chambers
(00:01:32) Self-Governed Tribal Healthcare Clinics
(00:16:24) Medicare Savings Program for Tribal Healthcare
(00:23:24) Tribal Healthcare: Self-Governance and Affordable Medicine
(00:27:26) High-Cost Medical Expense Reimbursement Fund
(00:36:20) Crucial Role of TPAs in Tribal Healthcare
(00:39:02) Reducing Fraudulent Charges through Healthcare Billing Transparency
(00:40:08) Exposing Wasteful Healthcare Practices
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:
TribalHealthcare #SelfGovernance #EducationalInitiatives #HealthcareSolutions #CatastrophicHealthFund #TPAs #TransparencyInHealthcare #HealthcareEfficiency #TribalSpace #QualityCare #FinancialEfficiency #LegalCompliance #selffunded #podcast
Tribal Healthcare, Self Governance, Educational Initiatives, Healthcare Solutions, Catastrophic Health Fund, TPAs, Transparency In Healthcare, Healthcare Efficiency, Tribal Space, Quality Care, Financial Efficiency, Legal Compliance, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"I think we need to do a better job of understanding each other and plugging each other in where we can help our clients to solve for issues that may not directly impact us, but make a world of difference for them." - Madison Baker
Madison Baker, from Marsh McLennan, has expanded her business and online presence exponentially over the last year by creating engaging posts and content on LinkedIn. If you’re just starting out in a producer role and you’re not using LinkedIn to build your brand, tune in this week to hear from Madison why it’s been so crucial for her business, and will be for yours.
Whether you’re an up-and-coming broker or consultant, or you’ve been in this industry for decades, there’s one thing that’s become pretty evident: if you aren’t engaging with your peers and clients through social media, you’re missing out on the chance to help so many more clients than you could through traditional methods.
But where do you start? Find out this week on Self-Funded with Spencer.
Chapters:
(00:00:00) Introducing Madison Baker
(00:00:48) The Importance Of Networking In Insurance
(00:16:37) Communicating About Risk With Clients
(00:21:44) Learning How To Always Bring Value
(00:34:05) Approaching Risk Differently In The Current Market
(00:46:39) Building A LinkedIn Brand From Scratch
(00:48:00) LinkedIn's Impact on Prospecting
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:
InsuranceNetworking #CareerProgression #ProducerTraining #BusinessPlan #AddingValue #TalentGap #RiskManagement #LinkedInBranding #BusinessGrowth #SelfInsurance #AIinInsurance #ClientSolutions #selffunded #podcast
Insurance Networking, Career Progression, Producer Training, Business Plan, Adding Value, Talent Gap, Risk Management, LinkedIn Branding, Business Growth, Self Insurance, AI in Insurance, Client Solutions, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“I realize there's this massive disconnect in the business model whereby you've got governments and health insurers paying billions and billions of dollars for what might be a not very effective therapy, and then there's all these potential cures, even, and much better treatments out there.” - Savva KerdemelidisSavva Kerdemelidis and Zan Lowe, of Public Good Pharma, joined me this week to talk about re-aligning the incentive structures for drug development. In our current system, drugs are often funded based on how much of their formula is patentable, and manufacturers will tweak the formulas in order to get new patents when they’ve run out. So how do we fix the system, for the public good? Savva’s solution is to “self-fund” pharmaceutical trials, through employers. These trials can be used to determine if lower cost drugs have the same or better effect than more expensive, patented ones (which they often do), and also demonstrate huge cost-savings for employers. Join us as we take on “Big Pharma” this week on Self-Funded.Chapters:(00:00:00) Introducing Public Good Pharma(00:09:29) Our Profit-Driven Pharmaceutical Industry(00:12:16) Drug Development Challenges in Patent System(00:13:19) Patent Monopolies and “Evergreening” Pharmaceuticals(00:17:44) “Interventional Pharmacoeconomics”(00:19:32) Clinical Trials for Affordable Treatments(00:29:18) Employer Involvement in Lower-Cost Drug Trials(00:33:37) Cost-Effective Pharmaceutical Incentive Strategy(00:36:55) Revamping Healthcare Incentives(00:45:28) Affordable Pharmaceutical AlternativesKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: #PharmaIndustry #DrugPricing #PatentSystem #Evergreening #ValueBasedPricing #InterventionalPharmacoeconomics #FormularyDesign #InnovativeIncentives #FixTheSystem #CostReduction #PersonalizedMedicine #AIinHealthcare #selffunded #podcastPharma Industry, Drug Pricing, Patent System, Evergreening, Value Based Pricing, Interventional Pharmacoeconomics, Formulary Design, Innovative Incentives, Fix The System, Cost Reduction, Personalized Medicine, AI in Healthcare, self funded, podcast--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"The US healthcare system is simple, easy to navigate and affordable. Said no one ever." - Guy Benjamin
Guy Benjamin returns to the show a year after his previous episode to share just how much Healthee has expanded in that time (spoilers: it’s 100x).
We talk about how Healthee’s role in the marketplace has shifted, what huge feature is on the horizon for them, and why Guy believes that the Healthee app deserves a spot on the bottom row of apps on your phone, next to your messages/email/Spotify apps.
The future of Healthee is bright, and I’m proud to highlight just how far they’ve come this week on Self-Funded with Spencer.
Chapters:
(00:00:00) Introducing Guy Benjamin
(00:07:56) Revolutionizing Healthcare With AI
(00:19:16) Using AI To Support Patients And Physicians
(00:27:01) Empowering Self-Service Healthcare
(00:35:26) Healthcare Bill Accuracy Through AI
(00:40:56) AI-driven Solutions for TPAs
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:
healthcaretransparency #programminghealth #engagementstrategy #AIinhealthcare #scalability #selfservicesolutions #medicalbillauditing #telehealthcostsavings #TPApartnerships #wearablesinhealthcare #healthtech #consumerempowerment #selffunded #podcast
healthcare transparency, programming health, engagement strategy, AI in healthcare, scalability, self service solutions, medical bill auditing, telehealth cost savings, TPA partnerships, wearables in healthcare, health tech, consumer empowerment, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"It's not always what you can do that makes you who you are. Sometimes the things that you don't do well create your style." - AG Ford
We have a bit of a different episode in store for you this week: an interview with a local illustrator AG Ford, who’s worked on children’s book series like Construction Site and Magic Tree House.
AG and I discussed just how hard it is to break into the world of illustration, what he learned in art school, and what his current work-life balance looks like.
We also talked about art in general, why being different is better than being better in the artistic world, and why he wouldn’t trade his current lifestyle for any other.
Chapters:
(00:00:00) Introducing AG Ford
(00:03:48) Embracing Imperfections for Unique Artistic Style
(00:17:23) Redefining Artistic Success Through Personal Journey
(00:21:06) Finding Balance: Artistic Creativity and Financial Stability
(00:25:55) Navigating Artistic Integrity in Commercial Ventures
(00:33:59) Illustration Process Timeline for Picture Books
(00:43:52) Diversifying Your Artistic Skillset
(00:53:17) Creating a Balanced Routine for Work-Life Harmony
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:
ArtisticStyle #EmbracingFlaws #BusinessArt #ArtisticJourney #CommercialArt #Illustrations #MarketDiversification #SelectiveProjects #WorkLifeBalance #BookPromotion #CreativeBalance #FamilyAndCareer #selffunded #podcast
Artistic Style, Embracing Flaws, Business Art, Artistic Journey, Commercial Art, Illustrations, Market Diversification, Selective Projects, Work Life Balance, Book Promotion, Creative Balance, Family And Career, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“If you're going to be the fiduciary, you have to protect the members, you have to protect the plan, and you need to defend that allowable to make sure that you're covering all of your bases." - Amy Pellegrin
We made it to episode 150! A huge thank you to every guest we’ve had on the show so far, and obviously to you, the listeners, for making the show what it is today.
For this special episode, we traveled to Des Moines, Iowa to meet with ClaimDOC, one of our sponsors, in early March and I hosted a panel podcast with Bruce Hansen, Amy Pellegrin, and Brad Hansen.
We talked about how each of them made their way to ClaimDOC, why it’s so important that ClaimDOC is a co-fiduciary with it’s clients, and why human customer support is especially welcome in the healthcare space. We also talked about the reference based pricing world at large and what ClaimDOC does to help its clients deal with balanced bills.
Join us for the 150th time this week on Self-Funded with Spencer as we talk all things RBP!
Chapters:
00:00:00 Welcome to Episode 150!
00:02:53 Member-Centric Healthcare Pricing
00:17:49 Navigating Healthcare Billing and Coding for Fair Charges
00:20:50 Claimdoc's Co-Fiduciary Role in Healthcare Operations
00:25:43 Better Healthcare Experiences Through Member Advocates
00:37:22 Navigating Balance Billing With An Advocate
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:
ReferenceBasedPricing #HealthcareBilling #FiduciaryResponsibilities #MemberAdvocacy #VendorRelationships #NetworkFreeOptions #BalancedBilling #ProviderRelationships #MemberAdvocates #HealthcareTools #HealthcareInnovation #selffunded #podcast
Reference Based Pricing, Healthcare Billing, Fiduciary Responsibilities, Member Advocacy, Vendor Relationships, Network Free Options, Balanced Billing, Provider Relationships, Member Advocates, Healthcare Tools, Healthcare Innovation, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"You're talking about the number one creator of wealth and security for people and one of their most important purchases. And like, how is this not in the employee benefits arena?" - Tommy Shumway
For the first time ever, a father and son joined the podcast together. Dave and Tommy Shumway, from CityWorth, joined the show to discuss an innovative, yet somewhat obvious, benefit that they’ve rolled out for employers to offer their employees: down payment assistance.
We spend a lot of time on the show covering new point solutions that employers can use to offer better benefits to their employees, but the idea of helping employee’s purchase real estate has yet to come up on the show. Dave and Tommy are able to offer this benefit thanks to their ability to operate in several states and their experience with doing these kinds of transactions many times.
The approach for employers is simple: offer employers help with their downpayment only after they’ve worked a set number of years at the company. The benefit is hugely beneficial with encouraging employee loyalty, and as Dave and Tommy shared, homeowners live much more stable lives and are much more productive than renters.
Join us this week on Self-Funded with Spencer for a discussion on home ownership as an employee benefit.
Chapters:
00:00:00 Introducing The Shumways
00:07:06 Financial Struggles in Entrepreneurship and Resilience
00:15:04 Cityworth’s Unique Approach To Real Estate
00:22:32 Real Estate As An Employee Benefit
00:24:32 Why Owning Real Estate Is So Important
00:28:05 Down Payment Assistance Based On Employee Loyalty
00:34:55 Shared Ownership for Non-Married Roommates
00:45:00 The Future Of Real Estate
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:
StartupChallenges #CityworthBusinessModel #RealEstateIndustry #MortgageEmployeeBenefits #HomeBuyingAssistance #EmployeeRetention #PrivatePortals #HomeownershipBenefits #RealEstateInnovation #RealEstateStrategies #RealEstateServices #EmployeeBenefits #selffunded #podcast
Startup Challenges, Cityworth Business Model, Real Estate Industry, Mortgage Employee Benefits, Home Buying Assistance, Employee Retention, Private Portals, Homeownership Benefits, Real Estate Innovation, Real Estate Strategies, Real Estate Services, Employee Benefits, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"Your fitness affects if you, even if you have a desk job. Your fitness is going to affect your performance over the long run, because it's your energy level." - Chris HamiltonChris Hamilton (Hotchkiss) needs no introduction on the show at this point; this is his fifth appearance! This time, Chris introduced me to the world of Continuous Glucose Monitoring (CGM) by putting a CGM in my arm at the very start of the show (be sure to listen to the whole episode to hear what my glucose level was!).We talked about why Chris tracks his health so intensely, what he does on a daily basis to stay fit and healthy, and why he believes fitness is extremely important, even if you work at an office job. Chris and I also discussed how we can incentivize employee’s to care about their health, and why that’s such a struggle for employers. Chapters:00:00:00 Spencer Tries Out A CGM Monitor00:16:51 Optimizing Work Performance through Health and Wellness00:20:52 Why Concierge Medicine Is So Valuable00:32:07 Data-Driven Health Monitoring00:47:38 The Long-Term Impact of Health Behavior Modifications00:57:19 Aligning Economic Incentives for Employee Health Improvement01:05:38 Investing In Your Employee’s Wellbeing01:13:45 Healthy Lifestyles At WorkKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: #HealthMonitoring #CGM #WellnessOptimization #FastingBenefits #ConciergeMedicine #EmployeeWellness #PersonalizedHealthcare #HealthyWorkplace #WorkplaceWellness #NutritionalAdvice #HealthCulture #HealthIncentives #selffunded #podcastHealth Monitoring, CGM, Wellness Optimization, Fasting Benefits, Concierge Medicine, Employee Wellness, Personalized Healthcare, Healthy Workplace, Workplace Wellness, Nutritional Advice, Health Culture, Health Incentives, self funded, podcast--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“We need to solve for all of that, so that it's more rewarding, more enjoyable, because that's where the cost savings will come in. That's where the innovation will come." - Ben Callaghan
Ben Callaghan, Chief Experience Officer at Empara, joined me this week to discuss how design can actually play a huge role in fixing many of the problems in our industry.
Before working at Empara, Ben actually attempted to launch a ski design company, and we discussed how that experience designing physical products still informs his design philosophy.
Ben focuses on the experiences that patients have utilizing healthcare, which is famously frustrating and complicated. Even if you have the best point solution in the world, it’s not going to be effective if nobody uses it, so it’s pivotal that the way that employees use healthcare is designed thoughtfully.
Even if you don’t know anything about design, I’d encourage you to check out this episode to learn how design impacts literally everything we do in modern America.
Chapters:
00:00:00 Meet Ben Callaghan
00:04:26 From Design Entrepreneur to Healthcare Innovator
00:09:31 Driving Innovation Through Healthcare Industry Collaborations
00:26:09 Digital ID Cards for Enhanced Member Engagement
00:33:38 Tailored Solutions for Buyer Engagement
00:44:58 Enhancing Healthcare Experiences with AI Technology
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:
HealthcareTransformation #TechnologyInHealthcare #InnovativeHealthcare #PatientExperience #DigitalHealthSolutions #HospitalAssistance #MemberEngagement #CustomizedHealthcare #FutureOfHealthTech #UserExperienceDesign #HealthcareIndustryInsights #ConsumerDrivenHealthcare #selffunded #podcast
Healthcare Transformation, Technology In Healthcare, Innovative Healthcare, Patient Experience, Digital Health Solutions, Hospital Assistance, Member Engagement, Customized Healthcare, Future Of Health Tech, User Experience Design, Healthcare Industry Insights, Consumer Driven Healthcare, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"If you do hard things now, your life will be easy in the future. If you do easy things now, your life will be hard in the future." - Nick Bellanca
Nick Bellanca joined me this week to get his perspective on something we don’t get a lot of on the show: selling as a consultant.
Nick and I talked about his upbringing, how he got onto the football team at the University of San Diego, and starting out working at a carrier (which he says is a great place for people to start in this industry).
Nick actually found himself working at a genetic testing startup for a number of years before transitioning into a sales role at MMA. I was interested to hear his outside perspective on selling as a consultant in the current insurance industry and what it takes to stay disciplined, as a human and as a salesman.
Whether you’re just starting out in sales, you’ve had a long career selling, or you don’t have anything to do with it, you’ll enjoy getting to hear Nick’s perspective on what it takes to make it in the current industry.
Chapters:
00:00:00 Meet Nick Bellanca / Running Marathons
00:07:44 Majoring In Accounting, Stumbling Into Sales
00:15:11 The World of Genetic Testing Benefits
00:17:49 The Challenge And Opportunity Of Changing Roles
00:22:01 Growth Mindset / Effective Communication In Sales
00:41:13 Wellness Programs / Wearables
00:52:41 Do The Hard Things Now
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:
CareerChoices #FinancialMotivation #SalesInsights #Adaptability #GeneticTesting #HealthcareInnovation #CareerTransition #PersonalGrowth #WorkLifeBalance #YouthfulMindset #EmployerWellness #SuccessPathway #selffunded #podcast
Career Choices, Financial Motivation, Sales Insights, Adaptability, Genetic Testing, Healthcare Innovation, Career Transition, Personal Growth, Work Life Balance, Youthful Mindset, Employer Wellness, Success Pathway, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"When your brain is programmed that the only way it can be done is through submitting your insurance and when your brain has been for years and years and years that accepting cash is criminal, it's very hard to break that." - Dr. KMy good friend Dr. K, founder of the NTTC Surgery Center and Hinkapin Health, joined the show to shed further light on what upfront pricing and value-based healthcare can do for this industry, employers, and patients. Dr. K came to America from India, and we discussed what it was like to encounter our health insurance for the first time was like as a physician. We discussed what lead him to choose Texas for his surgery center, why a surgery center is better and more cost effective than a hospital for surgery, and how he was able to determine pricing for his cash-based practice. Since founding NTTC Surgery Center near Dallas, Dr. K has stayed ambitious and is aiming to expand this model nationwide through Hinkapin Health. When practices publicly display prices and are able to compete with other practices to win business, everybody benefits; it’s a fundamental benefit of capitalism, and I’m always glad to be able to highlight practices like Dr. K’s. Chapters:00:00:00 Meet Dr. K00:06:56 An Outside Perspective On US Health Insurance00:15:25 Lowering Costs Through Bundled Procedures00:20:11 Building Out Upfront Surgical Costs00:22:14 The Importance Of Transparency In Bundled Procedures00:27:30 Infection Rates Are The Key Indicator Of Quality00:53:46 Why We Need Value-Based HealthcareKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: #healthcareinnovation #bundledsurgery #transparentcare #ambulatorysurgery #costeffectivehealthcare #qualitycare #healthcarecosts #emerginghealthcare #patientcentric #affordablehealthcare #healthcaresolutions #healthcarefuture #selffunded #podcasthealthcare innovation, bundled surgery, transparent care, ambulatory surgery, cost effective healthcare, quality care, healthcare costs, emerging healthcare, patient centric, affordable healthcare, healthcare solutions, healthcare future, self funded, podcast--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“It's the second largest line item that a company has, but they will stroke a check every month for a fully insured program without having data to support what those costs are for.” - Stephanie Koch
Stephanie Koch joined the show to share what it was like to work in benefits and HR in a fully funded company before moving to one that self-funds.
I invited Stephanie on to hear the employer perspective on the industry, but ended up getting so much more, as she’s truly on the cutting edge of healthcare benefits for her company Hendry Marine. We discussed what it’s like to deal with Reference-Based Pricing as an employer, why mobile clinics save lives and are crucial to self-funded plans, and why it’s so important to seek out nontraditional healthcare solutions in the current market.
No matter what aspect of our industry you work in, everything we do is for employers and employees, and there’s so much insight to gain from forward-thinking benefits managers like Stephanie.
Chapters:
00:00:00 Meet Stephanie Koch
00:01:36 Empowering Employers in Self-Funded Healthcare Systems
00:12:37 Challenges in Renewing Fully Funded Healthcare
00:32:44 Maximizing Healthcare Savings Through Reference Based Pricing
00:43:13 Evolving RBP Plans for Employee Benefits
00:51:56 Early Detection Incentives Through Preventive Wellness Exams
01:03:07 Strategic Healthcare Partnering for Self-Funding Success
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:
SelfFundedHealthcare #ReferenceBasedPricing #EmployeeBenefits #DataAnalysis #PreventiveExams #OnsiteClinics #CostSavings #ConsultingPartners #HealthcareImprovement #RBPStrategies #HealthcareCosts #TransparentSystem #selffunded #podcast
Self Funded Healthcare, Reference Based Pricing, Employee Benefits, Data Analysis, Preventive Exams, Onsite Clinics, Cost Savings, Consulting Partners, Healthcare Improvement, RBP Strategies, Healthcare Costs, Transparent System, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“I realized that 95% of the scheduled surgeries, like shoulder/knee repairs, back fusions, even some pelvic floor surgeries, they're no more effective than doing nothing at all, on average.” - Heidi OjhaHeidi Ojha, founder of Aware Health and recently a part of our MSK roundtable, joined me this week in studio to talk about why there are so many unnecessary surgeries performed in this country, why these surgeries happen in the first place, and how she’s trying to change that. Heidi’s worked as a clinician before founding Aware and estimates that about 95% of scheduled surgeries led to no more positive outcomes than doing nothing at all. This is especially alarming given that MSK is the biggest chronic spend on most health plans. Heidi and I also expanded on the notion that behavioral health plays a huge part in why and how so many surgeries are performed.Outside of the cost to the plan, unnecessary surgeries are often risky for the patient and can lead to complications, and even other surgeries that add even more risk. Join us this week to find out how we can stop unnecessary surgeries from happening.Chapters:00:00:00 Meet Heidi Ojha00:09:14 Exploring Non-Invasive Healthcare Options00:15:33 MSK Chronic Spend00:18:14 Managing Surgery Claims for Cost Savings00:27:11 Incentivize Care, Not Profit00:35:08 Claims Data Impact on Diagnostic Accuracy00:41:13 The Necessity Of Imaging00:50:14 Patient-Centered Approach To HealthcareKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: #MSKHealthcareCosts #ConservativeCare #BehavioralHealthExpenses #EmployerPlanSpend #FeeForServiceModel #DataAccessibility #DiagnosticAlgorithms #PatientEmpowerment #HealthcareSystemsOptimization #AvoidingSurgeries #ChronicHealthcareSpending #PatientCenteredCare #selffunded #podcastMSK Healthcare Costs, Conservative Care, Behavioral Health Expenses, Employer Plan Spend, Fee For Service Model, Data Accessibility, Diagnostic Algorithms, Patient Empowerment, Healthcare Systems Optimization, Avoiding Surgeries, Chronic Healthcare Spending, Patient Centered Care, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“In what other industry are you just not covered up with business if you're cheaper and better? This is America, for God's sake." - Keith Smith
This is a special episode with a special guest: Dr. Keith Smith from the Surgery Center of Oklahoma. Keith realized in the 1990s that the surgery system in America was exploitative and unfair, and decided to “rebel”, setting up a “parallel market” to sell surgeries direct to consumer at a listed price without any middlemen.
The idea of a consumer knowing the price ahead of purchasing a service (and not being charged afterward!) seems fundamental and obvious in every industry in our country, but it’s a completely revolutionary way of doing business in the healthcare industry. I talked with Keith about what made him realize that there had to be a better way of doing business, what it was like to be such a trailblazer, and why publicly posting his prices on his website was such a big deal.
If you want to hear an amazing conversation with a doctor who’s made real change in curbing price gouging in our industry, tune in this week on Self-Funded with Spencer with Dr. Keith Smith.
Chapters:
00:00:00 Meet Dr. Keith Smith
00:00:20 Spencer’s Son’s ER Trip
00:05:53 Transparent Surgical Bundle Pricing
00:22:17 Setting Surgical Prices Over The Phone
00:24:30 Allowing The Market To Drive Prices
00:40:21 Empowering Consumers By Posting Prices Online
00:42:30 Incentivizing Informed Healthcare Choices
00:53:03 Teaching Consultants On This Model
01:06:34 The Return To Free Market 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:
DirectPricingModel #HealthcareTransparency #BundledSurgicalProcedures #PackagedPricing #SelfFundedEmployers #ZeroDeductible #ConsultantsInHealthcare #FreeMarketHealthcare #HealthcareCostSavings #TransparentHealthcare #BetterHealthcareChoices #ConsumerCentricHealthcare #selffunded #podcast
Direct Pricing Model, Healthcare Transparency, Bundled Surgical Procedures, Packaged Pricing, Self Funded Employers, Zero Deductible, Consultants In Healthcare, Free Market Healthcare, Healthcare Cost Savings, Transparent Healthcare, Better Healthcare Choices, Consumer Centric Healthcare, self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"No one wins alone. And you know what? You can't do it on your own." - John Butler
John Butler, from JB Benefits Consulting, joined the show this week to talk the big-picture future of health insurance.
From AI sales tools to ICHRA plans to Health Sharing Plans, John Butler is constantly thinking about the future of this industry, and it was fun to hear about how his life experience as a consultant led him to where he currently is.
John and I also focused on making Americans actually healthier and how that could shift us away from the current “sickcare” mentality into an actually health-focused healthcare system.
Join us this week on Self-Funded as we focus on the future!
Chapters:
00:00:00 Meet John Butler
00:02:48 Driving Awareness of Health Solutions in Businesses
00:08:29 Managing Insurance Benefits for Employer Clients
00:12:46 Revolutionizing Sales and Marketing with AI Voices
00:15:38 Regenerative Medicine: Healing with Stem Cells
00:18:11 Health Sharing: A Cost-Effective Employer Solution
00:24:08 Real-time Reimbursements and Efficient Healthcare Solutions
00:31:47 Customized Healthcare Benefits for Cost Efficiency
00:34:22 Innovative Healthcare Models for Cost-Effective Care
00:51:17 Health Sharing Communities Transform Healthcare Insurance
00:52:30 Real-time Reimbursement Health Sharing 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:
MarketingAwareness #BrokerBusiness #AIinSales #StemCellHealthcare #EmployerCostSavings #HealthcareTechnology #EmployeeBudgetOptimization #CostSavingsStrategies #FutureHealthInsurance #HealthInsuranceInnovation #SelfInsurance #FullyInsuredPlan #selffunded #podcast
Marketing Awareness, Broker Business, AI in Sales, Stem Cells, Employer Cost Savings, Healthcare Technology, Employee Budget Optimization, Cost Savings Strategies, Future Health Insurance, Health Insurance Innovation, Self Insurance, Fully Insured Plan self funded, podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"I don't believe that random doctors should treat random patients in ongoing continuity of care. I don't think that transactional care is good for patients, and I know it's not good for physicians." - Chris MathewThe great Chris Mathew, Chief Growth Officer at Sniffle, joined me to talk about the future of Telehealth and the amazingly cost-effective ($15 a month!) benefits plan that Sniffle offers. Chris comes from an entrepreneurial family background, which pushed him to work at various startups over the years. Chris and I talked about why it was so important for him to be part of a startup even when he didn’t immediately see success, and how that drive led him to where he is today. Chris is really passionate about making the experience of healthcare better for both patients and physicians, and Sniffle’s “Aignosis”, an AI diagnosis tool, plays a big role in making doctor’s visits more effective and personal. Join us this week for a conversation on making doctor’s and patient’s lives better, and learning just how Sniffle can offer so many amazing benefits for just fifteen dollars a month. Chapters:00:00:00 Meet Chris Mathew00:08:09 Entrepreneurial Success Through Resilience and Perseverance00:14:20 Student Debt Impact on Physicians00:18:42 Real-time Savings with Sniffle Rx Platform00:30:05 Seamless Virtual Consultation Experience with Sniffle00:36:03 Personalized Diet Plans Using AI Technology00:45:36 Virtual Healthcare Network for Behavioral Wellness00:57:07 The Future of SniffleKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: #Entrepreneurship #HealthcareChallenges #AIHealthcare #TelehealthInnovation #VirtualCare #AIIntegration #PrescriptionProcess #BehavioralHealth #EmployeeBenefits #ResilienceInBusiness #ContinuityOfCare #MentalHealthAwareness #selffunded #podcastEntrepreneurship, Healthcare Challenges, AI Healthcare, Telehealth Innovation, Virtual Care, AI Integration, Prescription Process, Behavioral Health, Employee Benefits, Resilience In Business, Continuity Of Care, Mental Health Awareness, self funded, podcast--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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/
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"I always knew there was more. I always knew there was a different dimension to what this personnel or HR thing was." - Monica PanettaMonica 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 Panetta00:01:38 Employee-Centric Leadership: How HR Has Evolved00:02:38 Transitioning From “HR” to “People”00:05:00 Getting Started In HR00:13:16 Monica’s Career Journey00:21:31 Strategic Benefits Management As An HR Employee00:23:31 Empowering Employees Through Mental Health Support Programs00:24:32 Promoting The EAP Program Internally00:40:13 Recognizing Every Employee’s Journey00:41:39 Cultural Compatibility Evaluation In The Hiring ProcessKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow 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 #podcastChief 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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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 #podcastHealthcare, Transparency, Compliance, Innovation, Self Funded, Medical Costs, Consumer Information, Future Of Healthcare, Wearables, Data Driven, No Surprises Act, Regulation, Podcast
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
“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.pdfShare 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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"Health insurance has been so perverted that it becomes the one insurance that we go bankrupt when we use." - David ContornoI was super grateful to have David Contorno, founder of e-Powered Benefits, join me on the podcast for a conversation covering many aspects of the healthcare landscape, from how brokers can think outside the boxes to change the industry to how we need to change the way employers look at wellness plans.At a time when the average family premium is over $23,000 a year, there’s significant financial strain associated with healthcare that can and does lead to bankruptcy when healthcare services are actually used. David is a huge name in the healthcare landscape, so I was eager to get his thoughts on reforming the current system vs. completely rethinking how we approach healthcare in the first place.Join David and I on today’s show as we discuss, among other things, the future of what we do. Chapters:(00:01:53) Introducing David Contorno(00:09:32) The Financial Burden of Health Insurance In 2023(00:13:46) Investing in Employee Well-being for Cost Savings(00:17:40) Strategic Approaches to Lower Healthcare Costs(00:23:16) Leveraging Employer Resources for Healthcare Improvements(00:27:07) The Diminishing Value of Insurance Networks(00:34:33) Leveraging Employer Influence to Transform HealthcareKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow 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, Wellness Programs, Accurate Diagnoses, Cost Of Health Insurance, Innovative Approaches, Employer Power, Utility Of Networks, Changing Healthcare, Smaller Employers, Self Funded, Health Insurance Podcast--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
"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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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/
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
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How Should Insurance Brokers Get Paid - Jonathan LopezJonathan Lopez's career journey is a testament to the power of hard work and continuous learning. From a shoulder injury in the Marine Corps to earning a doctorate in leadership, Lopez has overcome obstacles and embraced opportunities to shape his professional path.Lopez's commitment to helping others extends beyond his career. He is actively involved in fundraising for wells in Tanzania through the Water Boys organization. This philanthropic effort not only builds wells but also ensures their maintenance and management, providing clean water to communities in need.In a recent episode of the podcast "Self Funded," hosted by Spencer Smith, Lopez and Smith delve into the complexities of incentives in the insurance industry. They emphasize the importance of transparency and integrity in navigating this field. Lopez highlights the issue of misaligned incentives and what he refers to as "dark money," shedding light on the need for greater accountability.The conversation also touches on shared savings arrangements and compensation structures for consultants. The evolving landscape of the insurance industry demands a closer examination of who gets paid and how much at each step of the equation. Lopez and Smith recognize the need for more transparency and integrity in the industry, challenging the perception of insurance as a greedy or stagnant field.Comedy emerges as a powerful tool for delivering harsh truths and sparking meaningful conversations. Lopez and Smith discuss the influence of comedy in addressing industry issues and dispelling misconceptions. They highlight the role of comedians like Joe Rogan, who use their platforms to share perspectives and engage audiences through humor.Artificial intelligence (AI) emerges as a game-changer in the insurance industry, particularly in underwriting and prepayment of claims. Lopez emphasizes the benefits of AI in analyzing patterns and resolving issues efficiently. The vast amount of healthcare data available allows AI to make data-driven decisions, leading to more accurate risk assessment and cost-saving strategies.Chapters00:03:29 From $20 to Doctorate: Overcoming Obstacles00:06:46 Climbing Mount Kilimanjaro to Fund Wells00:09:58 Sustainable well management for clean water access00:19:48 Misaligned incentives and dark money in insurance00:28:33 Incentivized cost savings through shared arrangements00:34:34 Prescription-based Comp for Insurance Consultants00:40:25 The Power of Comedy in Delivering Truth00:41:48 AI's Impact on Claim Management in Insurance00:50:45 Revolutionizing Underwriting with AI Technology00:59:27 Optimizing Insurance Plans w/ Pre-Underwriting Analysis--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
In this episode of the podcast Self-Funded with Spencer, hosted by Spencer Smith and featuring Sam Moen, the co-founder of MD Direct, the discussion centered around MD Direct's unique approach to optimizing healthcare and nutrition. MD Direct is a healthcare company that aims to bridge the gap in hospital nutrition and diet, focusing on individual performance and optimizing knowledge to help patients achieve their health goals.One of the key factors that impact MD Direct's approach is the disconnect in healthcare, particularly in musculoskeletal (MSK) and orthopedic care. This category is the largest spending category for employers in healthcare, accounting for a significant portion of healthcare costs. Sam Moen, co-founder of MD Direct, emphasizes the importance of addressing this issue, stating, "Getting good musculoskeletal health is what we think is the most important problem for employers to solve."Orthopedic care alone accounts for 5.76% of the GDP, making it a significant financial burden on both individuals and employers. The prevalence of musculoskeletal injuries, coupled with the high cost of treatment, highlights the need for a more efficient and effective approach to healthcare in this area.MD Direct aims to optimize healthcare visits, reduce leakage, and improve overall efficiency in the healthcare system. They specialize in triaging patients and determining the most appropriate treatment pathway, prioritizing starting with the least critical intervention. By utilizing data from wearables and predictive analytics, MD Direct aims to improve patient care and outcomes.One of the challenges MD Direct faces is the traditional healthcare model, which is not designed for efficiency. Moen acknowledges this, stating, "The traditional healthcare model isn't designed for efficiency. Unfortunately for you and me, the efficiency really is for the physicians. For billing insurance companies." MD Direct aims to disrupt this model by focusing on delivering the best clinical model to patients, with a focus on rapid diagnosis and treatment.Another important aspect of MD Direct's approach is the integration of nutrition and diet into healthcare. Moen highlights the lack of understanding and coaching on nutrition and diet in hospitals, stating, "The hospitals don't understand anything about nutrition and diet. They don't coach you on anything." MD Direct aims to address this gap by creating a connection between health and wellness, providing patients with the necessary information and support to make informed decisions about their nutrition and diet.MD Direct also works closely with employers to create clinical pathways and engage employees when they need it most. Moen emphasizes the importance of financial incentives for employees, stating, "If you can get the financial incentive to the employees, that's a great way to see engagement tick." By designing benefit plans that make it financially beneficial for employees to choose MD Direct's approach, they aim to increase engagement and improve overall health outcomes.Chapters:00:00:18 Revolutionizing Hospital Nutrition with MD Direct00:01:23 The Impact of Gluten on Scandinavian Health00:05:17 The Lizard Brain's Influence on Food Choices00:07:44 Disparity in MSK and Orthopedic Care00:08:30 Optimizing MSK and Orthopedic Care Efficiency00:15:58 The Impact of Unnecessary Surgeries in Healthcare00:21:28 High-Value Physical Therapy for Efficient Care00:26:44 Improving Musculoskeletal Health for Employers00:31:57 Utilizing MD Direct's Services for Employee Incentives00:40:39 Reducing Unnecessary Surgeries00:49:25 Wearable Data for Early Health Notifications--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
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The TPA Problem-Solver - Madeline Smith of MADDRSToday's episode features Madeline, CEO and Founder of MADDRS.Madeline Smith is a passionate insurance professional with a diverse background in writing, teaching, coaching, and consulting, and a strong desire to improve differentiation and value in the self-funded plan industry.
Madeline sees her role evolving to focus more on teaching, supporting, and consulting behind the scenes, rather than being at the forefront trying to sell and produce.
She is a strong advocate for challenging the status quo and finding innovative ways to make a difference in the industry. She criticizes the tendency for some in the industry to cut corners and engage in practices that contradict their claims of being different and radical.
Madeline is also the creator of the anthology book - "Whole Lotta $$$ in this MoFo", which is subtitled "An Employer's Guide to Navigating Legalized Larceny Within American Healthcare". I was fortunate to also to a contribute a chapter to this great book.
Buy it here - https://www.amazon.com/Whole-Lotta-this-MoFo-Navigating-ebook/dp/B0BLDMZ3NF
Join Spencer Smith and Madeline Smith on this episode of the @SelfFunded with Spencer podcast to learn more about her unique perspective and commitment to making a positive impact within her own lane.
Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=687c57dbe9cb4f39
Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286
Spencer Website - https://spencerharlansmith.com/
Spencer LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/
Madeline LinkedIn - https://www.linkedin.com/in/madeline-smith-dba/
MADDRS LinkedIn - https://www.linkedin.com/company/maddrs/Chapters:00:01:23 Embracing Unique Strengths: Differentiating MGUs and Carriers00:04:16 Evaluating carrier relationships for successful partnerships00:17:32 Improving Communication for TPAs00:21:45 Mediating and problem-solving in the insurance industry00:24:53 Misunderstood challenges faced by TPAs in healthcare00:32:41 Selecting the Ideal TPA for Clients00:37:06 Prioritizing projects based on shared values00:40:16 Unveiling the Hidden Forces: A Raw Industry Perspective00:44:31 Navigating Healthcare: A Comprehensive Guide00:49:43 Navigating Careers: A Guidebook for Professionals00:54:59 Driving positive change in the healthcare system
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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.
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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 Healthcare00:08:07 The Financial Strain of High Medication Expenses00:10:04 Healthcare Solutions for Expensive Medications00:18:23 Understanding Individual Healthcare Experiences00:20:50 A Convenient Alternative for Affordable Medication00:27:03 Accessing Free or Discounted Medications through PAPs00:33:13 Affordable Medication Sourcing from Abroad00:43:29 The Delicate Balance of Medication Cost00:51:00 Timing and Players in Solution Deployment
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Pharmacogenetics: Personalized Medicine for the FutureIn a this episode of the podcast "Self Funded" hosted by Spencer Smith, entrepreneur Nick Glimcher shared his journey from the world of commercial real estate to the healthcare industry. Glimcher's story highlights the importance of adaptability and seizing opportunities in different industries. He emphasizes the link between powerlifting and entrepreneurship, both requiring consistent effort and commitment for success.One of the key challenges in the healthcare industry, as discussed in the episode, is the complex landscape of insurance companies and payment issues. These challenges can be daunting and hinder the delivery of quality care. However, Glimcher believes that precision medicine holds the key to overcoming these challenges and revolutionizing healthcare.Precision medicine is an innovative approach that provides detailed and targeted care based on an individual's genetic makeup. Glimcher explains that precision medicine is the future of healthcare, with pharmacogenetics playing a crucial role in personalizing treatment plans. Pharmacogenetics is the science of determining which drugs work for an individual and which do not. While the science has been commercially viable since 2010, its widespread usage has been limited due to applicability issues.To address this issue, Glimcher's company, Blue Genes, has developed a software tool called The Blue Genes Solution. This tool aims to make pharmacogenetic data actionable in clinical settings. By integrating with pharmacy benefit managers (PBMs) and electronic medical records (EMRs), Blue Genes simplifies the interpretation of pharmacogenetic reports and provides instantaneous notifications to healthcare providers, ensuring that prescriptions are genetically efficacious.Cost mitigation in healthcare is a pressing issue that requires innovative solutions, such as precision medicine, and bipartisan support. Glimcher highlights the importance of government involvement in pushing for coverage determinations and legislation related to pharmacogenetics. He believes that there is bipartisan support for healthcare reform because humanity and caring are not political issues but fundamental aspects of being human.The episode also touches on the challenges faced by healthcare providers in adopting technology. Healthcare has been the last sector to embrace technological advancements, despite its critical role in keeping people alive and healthy. Glimcher emphasizes the need to make it easy for providers to integrate new technologies ethically, as they are motivated to provide the best care for their patients.In conclusion, the episode of "Self Funded" featuring Nick Glimcher sheds light on the intersection of entrepreneurship, healthcare challenges, and precision medicine innovations. Glimcher's entrepreneurial journey and insights highlight the importance of adaptability and consistent effort in achieving success. The challenges in the healthcare industry, particularly with insurance companies and payment issues, can be overcome through precision medicine and the integration of pharmacogenetic data. The efforts of companies like Blue Genes are aimed at improving clinical outcomes and mitigating the rising costs in healthcare. With bipartisan support and a focus on humanity and caring, the future of healthcare looks promising.Chapters:00:01:22 Nick Glimcher's Journey of Adaptability and Opportunity00:04:41 The Importance of Consistent Effort in Powerlifting00:08:13 Insurance Payment Challenges in Healthcare00:12:08 Pharmacogenetics: Personalized Medicine00:18:00 Overcoming Limitations of Pharmacogenetic Testing00:27:42 Genetic Makeup's Impact on Drug Effectiveness00:32:07 Transforming Healthcare with Niche Data Analysis00:46:02 Precision Medicine for Cost Mitigation in Healthcare--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
In this episode of the podcast "Self Funded with Spencer," host Spencer Smith sat down with CJ Brock, the CEO of Better Way Medical Group, to discuss a range of topics related to healthcare innovations and challenges. The conversation covered groundbreaking advancements in heart transplants, the shift of surgical procedures to office settings, and the obstacles faced by healthcare providers.One of the highlights of the episode was the opening discussion on the revolutionary heart box, a device that keeps the heart alive during transportation. CJ Brock described it as "science fiction to the max." This innovative technology has the potential to increase the success rate of heart transplants by almost 50%, expanding the donor pool and saving more lives, but also costs upwards of $1,000,000!Better Way Medical Group, founded by hand and wrist surgeons Dr. Chris Bates and Dr. Nathan Leslie, focuses on providing high-quality, low-cost surgical care in the office setting. This approach has not only improved patient care but also increased revenue. By leveraging advances in medicine and anesthesia, procedures can now be performed in a more convenient location, resulting in lower costs and reduced risks of complications.The podcast delved into the challenges associated with shifting procedures from surgery centers to physician offices. CJ Brock emphasized the importance of embracing change and innovation in healthcare. He highlighted the cost savings achieved through this shift and the positive impact it has had on both physicians and patients. By performing procedures in the office setting, physicians can see more patients, improve their quality of life, and ultimately make more money.The conversation also touched on the challenges faced by healthcare providers when dealing with payers in the industry. CJ Brock acknowledged that the goal is always to achieve zero revisions, complications, and infections, but he recognized that it is not always realistic. He emphasized the need to reserve surgery for patients who truly need it and explore non-invasive, non-surgical methods for treating underlying conditions.Throughout the episode, CJ Brock shared his personal journey from being a professional golfer to becoming a healthcare professional. His adaptability and determination were evident as he discussed the importance of problem-solving and embracing change on a daily basis. He quoted a mentor who said, "Life is messy. Change is messy. Organizations have to embrace messy." This mindset allows for incremental improvements and ultimately leads to significant progress over time.The episode of "Self Funded" featuring CJ Brock and Better Way Medical Group shed light on the innovations and challenges in healthcare. It showcased the potential of groundbreaking technologies like the heart box and highlighted the benefits of shifting procedures to office settings. The conversation emphasized the importance of considering the impact on patients, physicians, and the healthcare system as a whole when making decisions about healthcare innovations. By embracing change and continuously seeking improvement, healthcare providers can deliver better care, reduce costs, and ultimately improve patient outcomes.Listen now!Chapters:00:00:51 The Revolutionary Heart Box: Expanding Donor Pool00:07:42 Office-Based Surgery for Hand and Wrist Procedures00:14:08 Transitioning from Golf to Healthcare: CJ's Journey00:17:51 Innovative In-Office Hand and Wrist Surgery00:28:33 Shifting Procedures to Physician Offices00:33:31 Shift to Physician Offices for Cost Savings00:39:09 Innovative Solutions for Payer Challenges00:47:20 Minimally invasive needle treatment for elbow pain00:52:27 Driving change and innovation in healthcare--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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 Needs00:08:38 Finding Fulfillment Through Skills and Passions00:14:35 The Impact of ArmadaCare on Employee Loyalty00:16:33 Supplemental Medical Reimbursement Plan for Employees00:24:51 Tax Advantages for ArmadaCare00:26:42 Executive Medical Benefits00:31:58 Factors Considered in ArmadaCare Underwriting00:42:22 The Crossroads of Healthcare's Uncertain Future
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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
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Welcome to Episode 112 of Self-Funded with SPencer, featuring Landon Fielding of Brite!Navigating the world of employee benefits can often feel like an overwhelming and confusing task. From understanding different plans to making informed decisions, employees are often left feeling lost and uninformed. This is where Brite Benefits comes in. Co-Founded by Landon Fielding, a seasoned benefits consultant, Brite Benefits is a revolutionary benefits education platform designed to simplify the complex world of employee benefits. Catering to the Broker's Book of Business:One of the standout features of Brite Benefits is its software specifically catered to the broker's book of business. Whether you are a small company with just two employees or a large enterprise with 156,000 employees, Brite Benefits can handle benefits education for companies of all sizes. This flexibility ensures that every employee receives the necessary information to make informed decisions about their benefits.Integrations and Decision Tools:Brite Benefits goes beyond just providing education. It offers integrations for ACA plans, making it easy to import standardized plans and rate sheets. Additionally, its decision tools can handle robust RBP style programs, ensuring that employees have access to the most suitable options for their specific needs. This data-driven approach helps brokers drive their benefit strategies effectively.Empowering Brokers and HR Teams:Brite Benefits aims to empower brokers and HR teams by providing them with the necessary tools to drive their benefit strategies. The platform offers feedback from employee surveys, allowing brokers to identify solutions and make informed decisions. By involving spouses in the benefits process, Brite Benefits improves communication and understanding, leading to better decision-making.Driving Engagement and Participation:One of the biggest challenges in the benefits industry is low participation and engagement. Brite Benefits addresses this issue by providing an engaging and user-friendly platform. Users can access Brite Benefits through a magic link, eliminating the need to download apps or provide user information. The platform offers an overview of available benefits and provides embedded decision tools to recommend suitable options. By simplifying the benefits selection process, Brite Benefits encourages users to engage and make informed decisions.Conclusion:Brite Benefits is revolutionizing the traditional benefits guide experience by providing a digital platform that is easy to access, navigate, and understand. By offering integrations, decision tools, and ongoing communication, Brite Benefits ensures that employees have the necessary information to make informed decisions about their benefits. The platform's focus on education and empowerment benefits both brokers and employees, leading to cost savings and increased engagement. With Brite Benefits, the confusing world of employee benefits becomes simplified, empowering employees to make the best choices for their health and well-being.So, why not embrace the power of Brite Benefits and transform your employee benefits experience today?Chapters:00:00:00 Benefits education platform00:05:27 Career in Insurance and Benefits Consulting00:11:18 Revolutionizing Employee Benefits00:17:18 Challenges in the Benefits Broker Market00:22:53 Starting a Healthcare Software Company00:28:54 Brite Benefits: Revolutionizing Benefit Guides00:34:31 Driving Participation in Benefits00:40:24 Benefits education and software suite00:46:40 The Future of the Insurance IndustryLinks: @SelfFunded Channel - https://www.youtube.com/@SelfFundedWebsite - https://britebenefits.com/Brite Linkedin - https://www.linkedin.com/company/getbritehr/Landon LinkedIN - https://www.linkedin.com/in/landon-fielding-970808b4/
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Generic Drugs at Cost with ZERO Markup - ScriptCoIn this episode of our podcast, host Spencer Smith welcomes Zach Zeller, the founders of Scriptco. They are on a mission to disrupt the traditional healthcare system by offering transparent medication pricing and emphasizing the importance of affordable generics. Join us as we explore their journey, the benefits of Scriptco, and the potential for change in the healthcare industry.Unveiling the Dark Underbelly of Pharmacy Benefit Managers (PBMs):Zach Zeller discovered a startling truth about pharmacy benefit managers (PBMs) and their impact on consumers and pharmacies. He realized that copays were significantly higher than the actual cost of drugs, leading he and his co-founder to believe there was an opportunity to disrupt the marketplace. With this newfound knowledge, they spun off their three pharmacies and founded Scriptco in September 2019.Scriptco's Unique Business Model:Unlike traditional pharmacy services, Scriptco's business model focuses on monetizing the service, not the medication itself. Consumers can become members of Scriptco for $140 a year and quote their medications to see potential savings. On the business-to-business side, Scriptco charges $3 per member per month or $10 per utilizing member per month.Transparency and Seamless User Experience:Scriptco aims to provide transparency by disclosing the actual cost of drugs, determined by what they bought it for. They work with one manufacturer and 30 wholesalers, ensuring their inventory updates the quote tool in real time. This means that Scriptco's pricing is reflected in real time for partners utilizing their data, such as EMR companies and other platforms. By handling all fulfillment under one roof, Scriptco ensures a seamless user experience.The Power of Generics and Cost Savings:Scriptco differentiates itself from traditional PBMs by focusing solely on the fulfillment side of the pharmacy business. By utilizing Scriptco alongside generic medications, total spend on generics can be reduced by 25% to 30%. This is a significant cost-saving potential, especially considering that generics make up 92% of the market. Many low-cost medications have hidden costs built into their pricing due to PBM contracts, copay requirements, and retail pharmacy margins. Scriptco aims to eliminate these hidden costs and provide affordable options.The Ethical Obligation and Potential for Change:Spencer Smith and Zach Zeller feel an ethical obligation to shed light on Scriptco and its cost-saving potential. They believe that more people should be aware of the pricing issues in the healthcare system. With Scriptco, they have already saved one CEO $417 per life per year after all expenses. The potential for significant cost savings and a more transparent healthcare system is within reach.Conclusion:In this podcast episode, we explored the challenges and opportunities within the healthcare and pharmacy industry with Spencer Smith and Zach Zeller, the founders of Scriptco. Their mission to disrupt the traditional healthcare system by offering transparent medication pricing and focusing on affordable generics is commendable. Scriptco's unique business model, emphasis on transparency, and seamless user experience set them apart from traditional PBMs. By utilizing Scriptco alongside generic medications, significant cost savings are possible. It's time to bring transparency and affordability to the forefront of the healthcare system, and Scriptco is leading the way.Chapters:00:00:00 Zach Zeller: From Track Star to Medical Sales00:05:24 Transitioning into Retail Pharmacy00:11:25 Scriptco: Transparent Medication Pricing00:17:09 The Untapped Potential of Generic Medications00:22:55 Challenges of Robotic Drug Fulfillment00:28:53 Scriptco: Member Experience00:34:26 Scriptco: Direct-to-Consumer Pharmacy Model00:40:24 Challenges in Working with PBMs00:46:18 The future of healthcare--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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:
- 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.
- 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.
- 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.
- 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.
- 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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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:
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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.
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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.
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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.
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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.
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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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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:
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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."
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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."
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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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
Enhanced Benefits with VB - Eric Silverman - Voluntary Disruption
Are you looking for a way to get better engagement among your workforce without employees feeling like they just talked to a used car salesperson? Then you need to listen to the episode of Self Funded With Spencer featuring Eric Silverman!
In this episode, Spencer and Eric discuss the enhanced benefit industry, plan design and enrollment, and technology.
Voluntary Benefits are employer-sponsored benefits that provide employees with additional perks such as health insurance and retirement plans. Eric believes that the term "voluntary benefits" is not appropriate and prefers the term "enhanced benefits". He works with advisors and brokers to enhance employee benefits.
The episode also covers National Day, a tool Eric used for Personal Branding to gain visibility and grow his LinkedIn following to over 70,000 followers!
Finally, Eric and Spencer discuss Eric's podcast called "Rockstars Rocking". Eric has been blessed to know a lot of successful business people and entrepreneurs, so he likes to highlight people doing amazing work in their field.
Tune in to learn more about Voluntary Benefits and how to maximize them for success!
Links:
Voluntary Disruption Website - https://voluntarydisruption.com/
Eric's LinkedIn Profile - https://www.linkedin.com/in/silvermaneric/
Rockstars Rocking Podcast - https://voluntarydisruption.com/rockstarsrocking/
Timestamps: (00:00:00) Voluntary Benefits Industry (00:05:33) Enhanced Benefits (00:11:08) Voluntary Disruption (00:16:47) Broker Bonus Splitting (00:22:10) Communication in Benefits (00:28:11) Winning New Business (00:33:15) Consulting Business Creation (00:38:23) Starting a Podcast (00:43:38) National Day Branding (00:48:35) Networking Conversations
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
Pro Soccer, Super Bow Bids, and Formula One? - Neal Carter of Cvent
Neal Carter joins me on the orange couch to discuss the logistics of planning Large Conferences, the process of putting together a Super Bowl bid, the impact of COVID-19 on the hospitality industry, and the 2023 Formula One race season.
We also discussed the technical aspects of Formula One, the impact of Lewis Hamilton on the sport, and Neal's new Instagram channel - "American Gearbox".
Like me, soccer has been a huge part of Neal’s life, with Neal even spending a few years as a pro soccer player in the U.S.
As Neal currently works in the event planning industry, we discussed the huge undertaking of making a Super Bowl bid, the importance of everything from the days of the week in event planning, the amount of rooms needed per night, figuring out the proper room rates, the food buffet style versus plated, and the virtual component of events due to COVID-19.
All this and more can be seen (and heard!) in Episode 101 of @SelfFunded with Spencer!
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
Timestamps: 0:00 - Intro / Moving From Miami To Texas 3:22 - Neal’s Introduction To Soccer / Love Of Pele 11:29 - Playing Pro Soccer 13:46 - Hotel Sales Managing / Planning a Super Bowl Bid 23:09 - COVID’s Impact on Hospitality 29:11- Planning Virtual Events 38:23 - Falling In Love With Formula One 40:57 - The Netflix Effect 46:56 - Lewis Hamilton's Success 53:11 - Pit Strategies In Formula One 59:42 - Outro
entrepreneurship #soccer #superbowl #hospitality #virtualevents#formulaone #netflix #lewishamilton #maxverstappen #americangearbox
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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:
- Seth Denson, Head of Employee Benefits at @AcrisureOfficial
Company Website - https://www.acrisure.com/
LinkedIn Profile - https://www.linkedin.com/in/sethdenson/
- Dennis Fowler, Employee Benefits Practice Leader at @baldwinriskpartners8375
https://baldwinriskpartners.com/
LinkedIn Profile - https://www.linkedin.com/in/dennis-fowler-b105a6b/
- 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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
How AI Could Repair our Healthcare System - Meet Healthee
Join Spencer Smith in his latest episode of Self-Funded with Spencer as he delves into the world of artificial intelligence with Healthee and their co-founder/co-CEO - Guy Benjamin.
Guy shares the story behind "Zoe", Healthee's AI-based personal health assistant. The podcast also discusses biases and inefficiencies in the healthcare industry and how Healthee's platform uses AI to improve the health coverage services and experience for employees.
Spencer and Guy discuss how Healthee's mission is to provide accessible and transparent healthcare options for individuals, particularly in the United States where the costs for healthcare can be overwhelming.
They cover different features of the platform that include Telehealth services, personalized healthcare information, and appointments management. Spencer and Guy also talk about the potential in health coaching, nutrition, and fitness, and how the platform integrates wearable technology data.
Finally, they share how the younger generation, who grew up with technology, will drive innovation in healthcare and demand more transparency and accessibility in healthcare pricing.
Spencer and Guy wrap up by discussing how much value there is in Healthee's platform and why everyone should check it out.
Don't miss out on this engaging conversation that invites you to rethink the healthcare industry and discover how you can take control of your own health journey.
Listen now to the latest episode of Self-Funded with Spencer, available on all platforms.
Links:
Healthee's Website - https://healthee.co/
Healthee on LinkedIn - https://www.linkedin.com/company/get-...
Healthee on Instagram - https://www.instagram.com/get.healthee/
Healthee on Facebook - https://www.facebook.com/gethealthee
Healthee on YouTube - / @gethealthee
Timestamps:
[00:03:04] Introducing Zoe: Virtual Assistant for Healthcare [00:05:53] From Infantry to Fighter Pilot: One Israeli Veteran's Journey [00:08:47] Air Force, Entrepreneurship, and Life Lessons [00:11:34] Innovating Healthcare with Technology [00:14:18] Comparing Healthcare Systems: Israel vs The US [00:19:59] Personalized healthcare search tool [00:22:42] Smart Consumerism in Healthcare [00:25:26] Streamlining employee healthcare with Healthee platform [00:28:08] Choosing Healthcare Plans Made Easy [00:30:51] Employee Benefit Tracking and Analysis [00:33:35] Role of AI in Healthcare Coverage [00:36:28] Revolutionizing Healthcare with AI and User-Friendly Platforms [00:39:17] Opportunities for Wearable Technology in Health Coaching [00:42:00] Employer-Based Healthcare Solution [00:44:38] Cost-saving benefits of platform-directed healthcare [00:47:09] Adapting to Workforce Change for Health Care Success [00:49:51] Healthee's Mission to Improve Healthcare
healthcare #employeebenefits #selffunding #healthtech #AI #personalhealthassistant #entrepeneurship #healthcaresystem #medicalaudit #provider #smarterconsumerism #healthcareplanning #wearabletech #biases #ROI #transparency #healthcareexperience #customerexperience #innovation #Healthee #zoe
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
How to Create Better Wealth with The AND Asset - Caleb Guilliams
Welcome to the Self-Funded with Spencer podcast! In this episode, we are thrilled to have Caleb Guilliams, founder of Better Wealth and author of "The And Asset."
Spencer and Caleb discuss the power of life insurance as an investment tool, and how it can help people achieve their dreams while building wealth.
Caleb shares his inspiring story of overcoming his insecurities and using his fear of failure to become a successful business owner focused on helping people with money.
He explains how he used life insurance as a tool to improve his financial standing and how he founded Better Wealth Solutions, a company specializing in maximizing the benefits of life insurance.
Caleb emphasizes the importance of education and mentorship, and how these principles have been instrumental in his success. He also discusses the multidimensional aspect of money and the power of giving your money more than one job.
Throughout this podcast, you will learn about the benefits of overfunded life insurance, how to use life insurance in your investment portfolio, and the importance of creating content across multiple platforms to scale awareness of your business.
Caleb and Spencer also discuss their experience with public speaking and the role of video content in building momentum and credibility, as well as the impact of creating "Value Leverage"
Don't miss out on this exciting episode of Self-Funded with Spencer!
Chapters:
[00:00:09] Introduction of Caleb Williams and Personal Story
[00:03:01] Overcoming External Factors and Pursuing Personal Growth
[00:05:47] Early Career Success through Connection & Mentors
[00:08:47] Overcoming Impostor Syndrome in Investment Banking
[00:11:27] Caleb's journey out of banking
[00:14:05] Maximizing Wealth with Overfunded Life Insurance
[00:16:57] Wealthy Investors and Life Insurance
[00:20:05] Importance of Intentional Investing and Life Insurance
[00:22:50] Effects of over-funding on insurance contracts
[00:25:37] Intentional living and using life insurance for financial gain
[00:28:40] Teaching Entrepreneurs Financial Strategies & Value Leveraging
[00:31:57] Maximizing Product/Service Value and Leverage
[00:34:54] Leveraging Personal Experience for a Wider Audience
[00:37:32] Multiplying Your Money: Combining Assets for Greater Returns
[00:40:10] The Benefits of Public Speaking and Video Content
[00:43:12] Repurposing Content for Maximum Reach
[00:45:59] Content Creation and Frameworks
[00:48:47] Creating a Living Legacy
[00:51:25] Business as a platform for serving others
Caleb Websites:
Better Wealth - https://www.betterwealth.com/?r_done=1
The And Asset - https://www.andasset.com/
Buy the Book - https://www.amazon.com/Asset-Secret-Save-Your-Money/dp/1732724903
Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
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"
virtualcommunication #COVIDpivot #skillsdevelopment #selfdiscovery #contentcreation #dataanalytics #healthcareplan #employeecare #dataenrichment #technologyinhealthcare #transparency #diverseworkforce #gratitude #podcastguest #musicanddrumming #podcastsponsor #Springbuk
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
Join podcast host Spencer Smith as he sits down with guest Scott Smith from TRUE Network Advisors to discuss topics ranging from leadership to personal growth in the latest episode of Self-Funded with Spencer. Scott and Spencer delve into the concept of authentic leadership, exploring what it means to be "authentic" (a buzzword that makes them cringe) and striving to be the best version of oneself. The discussion also touches on the challenges of providing mentorship and guidance to others and feeling a sense of responsibility for the advice given. Impostor syndrome is also explored in detail, and both speakers reveal their experience with the phenomenon and how it can affect even the most successful individuals. The speakers also ruminate on the importance of taking care of oneself through self-care, delegating tasks, and intentionally spending time in activities that energize and fulfill oneself. Toward the end of the episode, the speakers discuss the importance of legacy and the impact that one has on others beyond just accomplishments. With topics ranging from personal growth to leadership and legacy, this episode of Self-Funded with Spencer is a must-listen for anyone looking for inspiration and practical advice on becoming the best version of oneself. Tune in now for a great discussion of leadership, mentorship, and creating a living legacy with Scott Smith!Timestamps[00:00:09] The Pressure of Podcasting for Influential Listeners[00:03:19] Guest's Public Persona and Use of Humor[00:06:41] Challenging the Notion of "Authenticity"[00:13:16] Evolving as a leader[00:20:09] Overcoming Adversity and Impostor Syndrome[00:26:55] The Importance of Investing in Personal Development[00:30:26] Finding Inspiration in Team Members[00:33:24] Building Connections[00:36:49] Building an intentional legacy[00:40:01] Creating a Legacy through Giving[00:43:11] Working with an Executive Coach[00:46:28] The Importance of Direct Communication in Leadership[00:49:29] The Importance of Self-Care for Work-Life Balance[00:56:09] Delegating and prioritizing tasks for productivity[00:59:10] Challenges of Helping Everyone and Time Management[01:02:10] The Importance of Joy, Legacy, and Authenticity[01:05:17] The Legacy of ParenthoodGreat Quotes:"Leadership really is caring about people. First and foremost. And if you really mean it and you show it, you demonstrate it, you put others before you, that's the very the foundation of leadership is caring about the people that you're working with" - Scott Smith"If you don't know yourself, and you're not attempting to know yourself, it's gonna be very hard for other people to trust you" - Scott Smith"It became less and less about me and more about what's possible with these organizations". - Scott SmithHashtags:#podcastpressure #leadershiplegacy #mentorship #employeebenefits #TrueNetworkAdvisers #authenticity #carefirst #selfimprovement #impostorsyndrome #legacybuilding #intentionallegacy #givingback #selfcare #delegation #relationshipbuilding #parentinglegacy #futureplans #podcastbeach #thankyouforlistening--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
Join host Spencer Smith on another episode of Self-Funded with Spencer, as he welcomes the PBM Princess, Rachel Strauss from EHIM.
In this engaging and informative podcast episode, Rachel shares valuable insights about the Pharmacy Benefits Management industry and EHIM's merger with ProCare Rx. Rachel and Spencer also take a deep dive into the importance of transparency in PBMs and how it affects the relationship between PBM and clients.
Rachel shares her journey of becoming a PBM consultant and how she found her niche as a problem solver, helping clients navigate complex healthcare systems and policies.
This episode discusses PBM selection and highlights the challenges of determining which PBM would work best for your company. Rachel shares her thoughts on a pricing model called "Cost Plus", which Mark Cuban has popularized recently in the world pf Pharmacy Benefit Management.
Additionally, the podcast highlights the need to align PBM incentives to client goals, the importance of understanding client priorities, and writing RFPs that align with them.
In this engaging conversation, Rachel shares her prediction on the reporting mandates that will track dollars and rebates, potentially affecting the earnings of some companies.
Another important aspect of Rachel's work is in fixing problems, rather than just identifying them. She explains that her role is not just about diagnosing issues but providing actionable solutions that can make a difference in the lives of patients and providers. Rachel's work is guided by her passion for improving healthcare access and quality, and she encourages others to find their own purpose and drive in their work.
Don't miss the fun banter between Spencer and Rachel as they share stories, opinions, and experiences. Tune in now for an engaging and informative conversation on pharmacy benefits management, self-funding, and everything in between!
Chapters;
[00:00:00] Introducing "PBM Princess" Rachel Strauss
[00:02:32] PBM Princess's Impact in Sales & EHIM's Merger
[00:05:50] The Rise of Transparent PBMs
[00:08:59] EHIM's Integration into ProCare for Advanced Tech
[00:11:59] Navigating emotional experience of company acquisition
[00:14:46] Navigating the Complex PBM Industry
[00:17:44] Pharmacy Benefit Management complexities and Mark Cuban's involvement
[00:20:26] Spread Pricing in Pharmacy Benefit Industry and Mark Cuban's Launch
[00:23:22] Strategies for Saving Costs in PBM Industry
[00:26:14] PBM Tactics and Rebates Issues
[00:29:05] The Deceptive Nature of Pharmaceutical Rebates
[00:32:04] EHIM's formulary strategy and committed rebate transparency
[00:35:00] Private Equity in PBMs
[00:40:37] Turning Healthcare Data into Actionable Insights
[00:43:30] Customized Services for Diverse Client Goals
[00:46:30] Third-party Vendor Blacklisting and PBM Priorities
[00:49:30] Debate on Ozempic coverage for weight loss
[00:52:27] Insurance Coverage of Bariatric Surgery
[00:55:19] Creativity and Collaboration in PBM
PBMs #pharmacybenefits #consultants #EHIM #ProCareRx #specialtydrugs #transparency #rebates #formulary #privateequity #dataanalytics #medicalcompliance #Ozempic #obesity #bariatricsurgery #creativity #partnerships #healthcareindustry #podcasts #podcastingtips #podcastingcommunity #businessstrategies #salesindustry #employersponsoredplans #specialtypharmacy #pharmacycosts
--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
How to Find Money in Medical Bill Errors - Zoe Holderness - Co-Founder of Slingshot Zoe Holderness, the CTO and co-founder of Slingshot, recently appeared on the podcast, Self-Funded with Spencer featuring host Spencer Smith. Slingshot is a software company that specializes in auditing medical bills. They automatically monitor every claim that comes through for an employer, finding savings and overcharges both for the plan and member. Zoe grew up in Charlotte, North Carolina, and later attended Georgia Tech, where she studied mechanical engineering and computer science. She then moved to California and worked at Tesla as a firmware integration engineer. She then moved on to work for Lyft, working in their E-Bikes division. She got to test out her own work, by riding the bikes everywhere after firmware updates, causing it to be referred to as a "dream job" for her. She also got the chance to work with a lot of women engineers while at Lyft, which is not typical in engineering jobs.Ultimately, an overcharge on a gynecology appointment led her down the path of creating her company - Slingshot. She received an itemized bill and she started reviewing CPT codes and calling the billing office to request audits. Eventually, she was able to get her bill reduced!Along with her co-founder Pranov Duggasani, they started to discuss the prevalence of these medical bill errors with friends of theirs and realized how common this issue was. They discovered that they were able to help their friends reduce their medical bills as well, by about 30% on average!Once they grasped the severity of the problem, they started to develop software to scale the solution instead of just supporting people manually. This led them to Y Combinator, where they received funding and learned the basics of how to start a business.Here are three key takeaways from Zoe's interview:1. Strive for clarity and transparency- Zoe and her team at Slingshot aim to provide clarity and transparency by uncovering any errors, overcharges, and incorrect coding in medical bills. This can save patients and their families a significant amount of money.2. Build a strong team- According to Zoe, Slingshot values teamwork, and each member of the team brings a unique skill set that together helps them to achieve success. Slingshot has a transparent, open culture that values input from all employees.3. Be passionate about your work- Zoe is passionate about technology and healthcare, which has led her to her current role at Slingshot. Her passion and enthusiasm for her work are contagious and serve to motivate the team to give their best.Listen to the podcast to learn more about Slingshot Medical Bill Audits and Zoe Holderness's journey in the tech industry.[00:00:00] Starting a Career in Tech[00:03:01] Working for Lyft[00:05:40] Intro to the Healthcare System[00:08:41] Streamlining Medical Billing with Software Engineering[00:14:20] Y Combinator program and Slingshot's benefits[00:17:17] How to Save on Healthcare Expenses[00:20:11] Slingshot's Role in Employer Plan Error Correction[00:23:04] Improving Hospital Billing Through Coding Changes[00:26:10] Improving Healthcare Billing Accuracy with Machine Learning[00:28:59] Benefits of Healthcare Claims Auditing[00:31:54] The Risks of Denial or Delay in Healthcare[00:34:54] Underutilized Nonprofit Hospital Financial Assistance Policy[00:37:59] Financial Assistance for Healthcare Access[00:40:49] Transparency and Tools Advancing HealthcareIf you are someone who has struggled with medical bills and navigating the administrative side of healthcare, Slingshot's expertise in auditing medical bills is worth listening to.#healthcare #medicalbilling #codingerror #SlingshotHealth #YCombinator #startup #MedicalBillAudits #employerbenefits#transparency #innovators #AIgorithms #healthcarecosts #telehealth #primarycare #healthtech #insurancebroker #claimdata #podcast #podcasting #ai #software--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
How Artificial Intelligence is Powering the Future of Risk with Matt Weaver of Gradient AIIn this episode of "Self-Funded with Spencer," host Spencer Smith chats with Matt Weaver, Director of Sales for Gradient AI, about Artificial Intelligence in underwriting tools for self-funding and other stop-loss initiatives.
Gradient AI helps underwriters make better assessments of risk, especially when limited loss and claims history exists, or even in the potential absence of claims data altogether.
This solution can be helpful in the world of self-funding when it comes to underwriting stop-loss insurance, especially for smaller employers.
Matt, who brings his expertise in the legal and sales domains, shares his experience working at large insurance defense firms after law school, selling insurance despite no prior knowledge of the industry, and eventually finding himself working with Gradient AI.
He explains how the Gradient AI tool uses advanced data analytics and Artificial Intelligence to accurately assess risk profiles for small and mid-sized business groups.
Their platform has revolutionized the underwriting process, making it faster, and much more efficient. They also discuss the challenges of predicting outcomes for the "messy middle" groups and how the pricing model can lead to a rollercoaster ride for employers.
Listeners will learn the importance of data to support the recommendation of self-funding and how Gradient AI is using AI to make more informed decisions in the insurance industry.
Join Spencer and guest Matt Weaver, as they share their insights into how AI is changing the future of employee benefits and A and H space.
Timestamps
[00:00:09] Artificial Intelligence in Self-Funding Underwriting Tools
[00:03:04] Experience working at an insurance defense firm
[00:06:06] Transitioning from Insurance Defense to Benefits Consulting
[00:09:01] Starting in Insurance Sales
[00:14:42] Transitioning from traditional brokering to consulting
[00:17:53] From PEO Consulting to Joining Gradient AI
[00:21:04] Gradient AI's Role in Predicting Risk for Insurance
[00:27:37] Challenges in Underwriting Self-Funded Businesses
[00:30:45] Distinguishing Factors in Predictive Analytics
[00:37:14] Risk Scores and Cost Estimates for Health Insurance
[00:40:30] Success of Data-Driven Underwriting Tool
[00:43:35] Revolutionizing Underwriting in Insurance Industry
[00:46:33] Innovative Pricing Model & AI in Health Benefits
[00:52:56] The Power of Claims Data in Insurance Consulting
[00:55:47] Maximizing Benefits of Self-funded Healthcare Plans
[00:59:02] Challenges of Self-Funding for Employers
[01:01:59] Procurement processes for clients and use of data
[01:05:26] The Future of Artificial Intelligence in Insurance
[01:11:47] Risk Analytics and Artificial Intelligence in Insurance
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A Professional's Guide to Bespoke Fashion in 2023 - Will Russ - R6 ClothierGet ready to elevate your fashion game with Spencer Smith and his guest, the founder of R6 Clothier, Will Russ. In this exciting episode, they discuss men's fashion in a professional setting, sharing insights from Will's experience in door-to-door sales and the importance of relationships and credibility in starting a successful clothing business. They delve into the mechanics of setting up a custom clothing business, discuss current fashion trends, and emphasize the value of investing in high-quality, custom-made attire. They even announce a new business venture of Will's called "Tailored Gents, which simplifies the process of purchasing custom outfits. Here are three takeaways from Will's journey as an entrepreneur:1. Embrace your failures: Will admits that he was initially bad at selling clothing because he lacked context, having grown up with a perception of clothing through the limited scope of brands like Tommy Hilfiger and Polo. However, he didn't let this deter him, and with help, he persisted and learned the ropes of the clothing business.2. Opportunities come in unexpected ways: Will's journey from being a door-to-door book salesman to a professional men's fashion brand owner might not seem linear, but it's not uncommon for entrepreneurial journeys to have twists and turns.3. Passion for the product: Will's interest in sales stemmed from an interest in the product. He enjoyed being around people and found enjoyment in selling clothing over other products. It's critical to have passion for what you're selling, and it's often what sets entrepreneurs apart.Don't miss this enlightening conversation that will boost your confidence and respect level both inside and outside the office. Tune in now to Self-Funded with Spencer!Timestamps[00:00:09] Interview with Will Russ on Men's Professional Wear[00:03:44] Door-to-Door Sales: Challenges and Triumphs[00:07:03] Mastering Salesmanship with a Steady Mindset[00:10:30] Experience in Fashion Industry and Building Client Trust[00:13:56] Career transition struggles and realization[00:17:36] Starting a Clothing Business from Scratch[00:21:12] Leveraging Relationships to Start a Business[00:24:13] Metrics & Scaling for Small Businesses[00:27:13] Cost-effective Clothing Business Marketing Strategies and Professional Attire Trends[00:30:30] Efficient RFP Management and Fashion for Business[00:33:46] Custom-made clothing features and options[00:36:37] The Benefits of Custom-Made Clothes[00:39:56] The Popularity of Sneakers with Formal Attire[00:43:06] The Importance of Professional Dressing[00:46:21] Taylor Jent - A Simplified Custom Clothing Experience[00:49:34] Revolutionizing Online Clothing Subscriptions[00:52:56] The Future of Professional Fashion[00:56:07] Impact of Appearance on Confidence and Perception#mensfashion #professionalwear #entrepreneurialjourney #sales #customclothing #door2doorsales #coaching #startup #custommade #tailormade #businessattire #casualwear #sneakerswithsuits #investing #selfconfidence #clientrelationships #fashiontrends #podcast #TailoredGents #R6Clothier #bespoke #bespokemenswear #fashion #fashionblogger--- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
Ross Conner, CIC, CRM is a Partner at Hotchkiss Insurance in Fort Worth, TX, where he focuses on helping middle market and franchise businesses grow through a compliant, consistent, and streamlined risk management program.
Oh, and Ross is in Property and Casualty, not Employee Benefits. Now you might ask what is a P&C guy doing on a self-funded benefits podcast?!
Well besides being hilarious (follow him on LinkedIn here ----> https://www.linkedin.com/in/ross-conner-cic-crm-9b1189a/ ) and having a truly remarkable life story, Ross also created a unique insurance captive to help manage risk at a very large children’s activity franchise.
Ross started his career as a general contractor building high-end homes, but an unfortunate downturn in the economy coupled with being overleveraged with inventory he couldn't sell ultimately led him down the path of bankruptcy.
Ross was then in a position where he had to reinvent himself and eventually found his way into the world of insurance.
In this episode, Ross emphasizes the power of Networking.
He says networking played a crucial role in helping him turn his career around and how your network can create opportunities, generate leads, and open doors that can help you grow your business.
Here are three tips to make the most of your network:
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Attend events and conferences: One of the best ways to meet like-minded people and expand your network is by attending industry-specific events and conferences. These events bring together professionals from different backgrounds who share similar interests and can create opportunities for business collaborations.
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Build genuine relationships: It's important to approach networking as an opportunity to build relationships rather than simply sell yourself or your business. Take the time to listen to others, understand their needs, and offer support and assistance where possible.
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Follow-up: After connecting with someone, take the initiative to follow up with them. Send an email or set up a phone call to check in and keep the lines of communication open.
This is a great episode for anyone who likes risk management, property and casualty discussions, insurance captives, personal growth, and a great redemption story!
contentcreation #insuranceindustry #careerjourney #entrepreneur #finance#bankruptcy #familylife #captives #propertyandcasualty #insurancecompliance#crossselling #technology #cybersecurity #emergingrisks #AI #podcastdiscussion#ChatGPT #businessstrategy #LinkedInmarketing #takingrisks#experiencedsharing #podcastingtips
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CHRA Explained - Everything You Need to Know About Individual Coverage HRA's with Kyle EstepSelf-Funded with Spencer, hosted by Spencer Smith, is a podcast for those looking to strategically navigate the complex landscape of health insurance. In this episode, Spencer speaks with guest Kyle Estep from Take Command Health. Kyle Estep is the VP of Growth for Take Command Health.Kyle spent 8 years of his career early on consulting for Deloitte, one of the top consulting firms in the world. He also spent a year in South Africa for Awethu, focused on identifying, developing, and investing in world-class entrepreneurs. He worked alongside the CEO & COO to launch the incubator in Johannesburg, South Africa.His insurance-specific career began at Oscar Health, which was based in New York, and he was hired to help launch their Texas business unit. Kyle built out the sales and distribution team there, helping them scale across the country.His time at Oscar initially led to meeting Jack Hooper, the CEO and Founder of Take Command Health, which offers HRAs for small business health insurance.Specifically, for this episode, we focused on the value of an ICHRA, also known as an Individual Coverage Health Reimbursement Account.An ICHRA is a way for an employer to give tax-free money to its employees so that they can find the health insurance plan that best suits their needs. ICHRAs allow an off-ramp for employers who no longer want to be tasked with managing the risk of a health plan on behalf of their employees, but who still want to provide them with financial support to purchase their desired plans.It is NOT fit for every situation and sometimes depends on the affordability and diversity of plans being offered on the individual market in that specific geographic location.This is where Take Command comes in, in not only consulting around the employer's goals but also analyzing what individual plans are available to benchmark against group health options the employer is quoting as well. In addition to this analysis, Take Command's special sauce is their service around the seamless transition to an ICHRA so that the members still feel supported by their employer.If you have ever wondered what an ICHRA was, what types of companies it works for, and how an employer goes about switching to this arrangement, then this is the episode for you!#SelfFunded #Deloitte #HealthInsurance #ConsumerProtection #ICHRA #Tax #ACA #IndividualMarket#SmallBusinesses #AffordableCareAct #TakeCommand #PublicPrivatePartnership #AdviserOptions --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support
Welcome to Self-Funded with Spencer, a podcast that explores how employers can most effectively manage their health plan costs by "Self-Funding" their insurance.In this episode, Spencer talks to Kari L. Niblack, Esq. from Blackwell Captive Solutions, a risk attorney with 30+ years of experience in the business.Kari shares how her law career prepared her for sales, and her experience with the obstacles faced by women in the benefits industry, especially those seeking leadership positions. Personally, Kari comes from a racing family, with her aunt Roxi was a racecar driver back in the 1980s, long before Danica Patrick became a household name. Kari got to see her start with "quarter midgets", and then before graduating high school, leave for Europe to pursue a professional racing career.Kari herself is an avid backgammon player, learning from Roxi after she brought a board back from Europe. She is actually highly ranked in the world as a backgammon player, and plays nearly every day online with players all across the world!Kari also talks about the concept of “captives”, and how companies of all sizes can benefit from them. She also discusses with Spencer why they are becoming increasingly popular. Finally, Kari touches on the importance of giving back and helping those who have helped you. Self-Funded with Spencer offers an engaging and informative look into the world of health benefits, risk management, and self-funding.Tune in now and take away valuable advice and experience from our guest Kari L. Niblack, esq., president of Blackwell Captive Solutions!#captives #insurance #riskmanagement #mentor #leadership #women #sales #employeebenefits #SelfFundedWithSpencer #BlackwellCaptiveSolutions #RiskAttorney #DanicaPatrick #Backgammon #Plansight #CaptiveCompanies #CarrieUnderwood #Innovation #Flexibility #Agility #Stability #racecar #racing #indycar #formula1 #nascar--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
This is a great episode for anyone interested in what it is like to succeed within the largest insurance brokerage in the United States, and partner upmarket with large and jumbo employers.
Travis is EVP at Marsh McLennan Agency (MMA)
Travis was an exceptional wrestler in high school but hung up his wrestling singlet in college, where he studied general business at Westminster College in Fulton, Missouri.
Like quite a few of my guests in the past, Travis has a thrill-seeking side, being an avid skydiver AND scuba diver, where he jokingly says to me, "I guess I am just not comfortable on the ground"!
Travis said that he didn't start skydiving until 2001, and since then is nearing 500 jumps in total. He did it initially to conquer a fear of heights and eventually fell in love with the sport, turning it into a real passion.
Heading under sea level, Travis picked up scuba diving while traveling with his wife, realizing that this was an activity he could share with her and bond over.
Travis began his benefits career working for a PPO Network in Atlanta, Georgia. Early on, his role was to review massive amounts of PPO contracts where he uncovered over $1,000,000 of missing revenue. Because that company was going through due diligence to be acquired, Travis unknowingly assisted in increasing the valuation of his company. This helped him personally as well, receiving an offer to join a startup in Athens, GA with one of his mentors.
Travis found himself down in Dallas next with MHBT, where he ultimately joined his current firm through an acquisition of MHBT by the Marsh McLennan Agency, also known as "MMA", the largest insurance brokerage in the United States.
Travis found himself gravitating toward self-funding as he started to get exposed to larger prospects and clients. He found that through the vehicle of self-funding, these employers were seeking more control over their healthcare spend, and self-funding offered a mechanism in which to do that.
Travis taught himself self-funding in about two weeks by picking the brains of his mentors and peers at MHBT, as well as reaching out to trusted stop-loss vendors.
Travis is also a very astute salesman, understanding body language, behavioral psychology, and being able to read a prospect's openness to the ideas he's presenting. Being in the industry for 20 years, he has also built up a great referral network, something he calls a "Center of Influence", which allows him to be more choosy about who he works with, and the ability to sit down with an audience more receptive to his strategies.
Chapters:
- 0:00 Sartain vs SarTAIN
- 2:00 Intro to Travis
- 9:20 Sky & Scubadiving
- 17:00 Enter the Benefits World
- 28:14 MHBT to Marsh & McLennan
- 35:00 Self-Funding
- 48:43 The CAA
- 54:45 Incentivized Healthcare
- 57:53 The Big Picture
- 1:02:39 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
The Black & White Truth with Kareim Cade and Andy Neary.
This episode features the duo of:
1) Kareim Cade - Owner and CEO of the Great Lakes Benefits Group
2) Andy Neary - Founder of Complete Game Consulting
Together they make up a partnership called "The Black & White Truth".
Their program has 3 pillars:
- Modernize how Salespeople are Trained
- Redefining Leadership
- Encourage Diversity of Thought
Black & White Truth combines collaborative coaching, on-site workshops for insurance agencies, and keynote speaking at industry conferences and large employer events.
Kareim grew up in a house where his mother was in the insurance business, working for New York Life, even working for her when he was really young, getting paid $.25 for each folder he put together for her! Kareim studied at a historically black college named "The Clark University" in Atlanta, where at first he spent more time partying than learning. Eventually, his mom told him they were only paying for 4 years, so Kareim knew he had to get his act together right away. Kareim studied insurance and risk management, and walked away with a degree he had no idea would ultimately catapult him into the life of a successful benefits agency owner.
Andy Neary is a former professional baseball player, and a one-time insurance producer himself, who ultimately became a marketing consultant and founder of Complete Game Consulting. His company focuses on helping insurance producers build their own personal brands using content and modern sales training. His methods have helped countless producers and agency owners transform their outdated prospecting processes, by leveraging video content and LinkedIn to maximize their visibility with potential buyers.
There is a ton more to the story of Any and Kareim individually, which you can hear all about in Episode 84 of the Self-Funded with Spencer Podcast!
Chapters:
0:00 Intro to Kareim
10:40 Intro to Andy
15:50 Building an Agency
20:09 The Power of Coaching
24:30 The Black & White Truth
31:55 The 3 Pillars
43:23 Power to the Content Creators
44:55 Updating Training Methods
48:46 Leadership Redefined
50:40 Diversity of Thought
54:22 The Big Picture
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Jason Scott is First Vice President for Alliant Insurance Services in Dallas, TX.Jason originally learned the art of sales from his Dad, who taught him how to sell without being "sales-y". He also taught Jason the power of getting to the yes or the no as fast as possible, because the "maybe's" are career killers. His Dad was actually instrumental in helping popularize a seasoning in the United States called "Tajin", which is a mixture of lime, chili powder, and salt, and is very popular within the Hispanic community.His first sales role was at Paycom, which inadvertently opened the door for him to enter the insurance world, as one of his payroll prospects was a large regional insurance brokerage in Dallas called MHBT. They kept calling him back multiple times to present the same thing, but to new people, and he started to realize they were actually interested in hiring him to work for the firm instead!Jason was offered roles within MHBT in both the Employee Benefits and Property & Casualty departments, but he gravitated toward EB because there were a couple of other young producers in that department he liked, plus he found the subject matter more interesting and creative.Eventually, he found himself at Alliant after the acquisition of his prior firm called Crystal & Company, and there he had the opportunity to help hone best practices within his new, larger employer. Big on company culture, Jason stresses the idea of servant leadership and making sure the people that work for you feel valued and supported.Jason isn't all business, though, as he also coaches his young sons in baseball at a very competitive level. However, it is not all about talent for him, as Jason brings the emphasis of team culture from his work life to the baseball diamond, and won't accept new players onto the roster based on pure ability alone. They also need to be respectful, and polite to their coaches, and he also manages the expectations and egos of the parents as well.In the big picture of healthcare, Jason is bullish on the private sector to solve the problems we encounter and believes more consumer-driven plans will eventually prevail. He also believes innovation in our space is only going to accelerate, and that the BUCAH's of the world will continue to stay relevant as long as they can, but face stiff competition from new entrants into the market.Chapters0:00 Intro to Jason12:15 Bringing "Tajin" to the US16:42 Developing Sales Skills20:32 Working for Alliant32:00 The Importance of Company Culture36:16 Lessons from Baseball42:55 Respect from your Peers47:13 The Future of Healthcare52:14 Closing Thoughts--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Can one app manage pricing, communications, and payments for health plans?
In short, YES! Medxoom "unifies member identity, pricing, communication and payments into one, easy-to-use app".
For Episode 82, my guest is James the EVP of Strategy and Growth for MedXoom.
His hobbies are triathlons, for which he trains 16-20 hours a week to prepare for events, and scuba diving. Jame calls himself "a back-of-the-pack triathlete", and recently he had to back out of a full Ironman race in Florida about 36 hours prior to it starting because of a lung infection.
James has also performed well over 500+ deep dives, saying it is the most peaceful and exhilarating experience simultaneously. He even once found a 1-carat diamond ring during his adventures, as well as visited many underwater shipwrecks.
James started his career out in the legal world, then moved on to sales with ADP, then PEO sales, before finding himself in SaaS tech centering around human resources with Namely.
His current company is MedXoom, which is a technology platform that has the ability to improve the financial outcomes for both plans and members.
Medxoom creates a true white-labeled member experience, with clients ranging from Third Party Administrators, Health Plans, Brokers, and many other solution providers selling out to employers directly.
Health Plans have nearly an infinite number of combinations of solutions folded together including things like Telehealth, Direct Primary Care, carved-out PBM’s, Reference Based Pricing, etc, and Medxoom allows the administrator to bring all of those components together, white-label in one singular experience, so the member has one place to go.
Members can do things like:
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Use their Benefits Wallet
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Search for Care
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Engage with a Care Navigator
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Align with a Provider on Price
James said one of the reasons they get such good member engagement is that many of their employer clients have gone fully digital, even eliminating plastic ID cards. “You go fully digital and you get adoption”
With plans who have done this, they see 70% + in downloads and enrollment within the first week of launch.
They also partner with 3rd-party data providers in order to large ingest machine-readable files with pricing data so members can easily search for cost details of care, which helps employers be compliant with the CAA.
In the near future, the app will even be able to recognize if certain procedures are searched for and turn that information over to a case manager to proactively help determine the best course of action.
Medxoom is also assisting with improving the provider payment process, using something called a “Single Payment Credential” or SPC card. This functions as a single-use, virtual credit card loaded with plan dollars allowing for a closed-loop transaction that pays the provider in full. Medxoom takes it a step beyond and can even float the money for their clients to ensure a frictionless transaction. All of this has led to 100% acceptance of payments using this method.
Best of all, Medxoom’s clients are giving them data that shows on average, using the SPC method of payment, they are realizing a 40% reduction in unit cost versus traditional network arrangements!
Chapters:
0:00 Triathlons & Skydiving
11:58 James' Career Path
20:30 Intro to Medxoom
31:20 Medxoom Partners
38:53 Solving the Payment Problem
46:07 Who is it for?
55:00 Future of Healthcare
56:50 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Join me as I sat down with Ahmed Marmoush, Founder and CEO of Handl Health to hear his story, and learn more about Handl Health.Ahmed was born in Egypt but grew up in New Zealand, where he studied at the University of Auckland and received a Bachelor of Pharmacy. He then went to work at a Hospital in New Zealand as a clinical pharmacist where he got to experience everything from primary care in the field to geriatric care in a hospital setting. This gave him a ton of exposure to healthcare operations, where his frustration with the status quo in the system started. An encounter with the US Healthcare system, where he was charged $800 for a blood test when he was under the impression that his preventative care was free, introduced him to the complex insurance model of care in America and sent him down the path that eventually led to the creation of Handl Health.Handl Health is a consumer-facing application that employers use to help them comply with the healthcare price transparency legislation, known as the CAA.With Handl, members can digitally shop for healthcare, arrange their appointments, and manage their personal healthcare finances with ease.The ideal employer for Handl's solution is a self-funded employer, typically above 50 lives, who want to offer a care management tool for their employees.Handl ingests thousands of terabytes of data from hospital pricing files, normalizes that data, and uses it to assist in the member shopping experience for healthcare.The focus is not just on price, but the quality of care being delivered as well.Handl Health is poised to make a big impact on the healthcare industry, and it's an exciting time to witness the digital transformation and transparency push happening in the marketplace.Don't miss this episode and learn more about the future of healthcare with Handl Health!Chapters:0:00 Intro to Ahmed4:33 Quarantine in New Zealand9:15 Intro to New Zealand Healthcare20:52 Early Entrepreneurship27:53 What is Handl Health?36:35 Compliance with the CAA41:22 Price Shopping Tool45:55 Public vs Private Healthcare51:20 Future of Handl Health54:35 Closing Thoughts--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
This episode is focused on the topic of Direct Primary Care, also known as "DPC".
The DPC model transforms primary care into a membership-based model, rather than the traditional fee-for-service model. The goal is to provide all of the same routine services that patients receive from their primary care physician but eliminate the incentive for fast patient turnover, which often leads to a decrease in the quality of care provided.
Our guest, Andy Bonner, the President & CEO of Healthcare2U, shares his experience in the healthcare industry and how a personal misdiagnosis led to the creation of Healthcare2U, a company that offers a hybrid model of primary care services.
He also shares what he learned working in business process outsourcing, where he helped develop the concept of "Near-Site/On-Site" and how it has led to the creation of Healthcare2U.
In this episode, you will learn about the benefits of DPC, including:
*More time with your doctor
* Stronger patient-doctor relationship
* Improved physician quality of life
* Elimination of claims to insurance
* Less Administrative Burden
Tune in to this episode to understand the potential of DPC and how it can change the way we approach primary care!
Chapters:
0:00 Intro to Andy Bonner
8:36 Andy's Cancer Scare
14:30 A Calling to Healthcare
22:00 Direct Primary Care Defined
29:31 HealthCare2U Explained
35:48 Coordinating Medical Records
40:00 Scaling DPC Nationally
47:28 Who is DPC For?
55:12 The Big Picture
59:59 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
This episode is all about entrepreneurship. The highs and the lows, and everything in between.
Gabe knew he was going to be an entrepreneur from an early age, recalling that he didn't get the best grades, didn't love to follow rules, and even recounts knowing at the age of 14 he was going to build his own businesses.
He studied entrepreneurship in college at Baylor University, but outside of making friends and meeting his wife there, his belief that he would have been better off taking the $150k spent on four years of school where he learned somewhat outdated information, and just setting up his own painting or landscaping business instead.
Gabe also has a fantastic story to tell about financial redemption.
From being on the brink of bankruptcy, where he had to move his wife and newborn child into a studio apartment after an oil market crash crushed his family business, to founding and building Factur, with 57 employees, explosive growth, and a vision to create a "100-Year Company", Gabe's story should resonate with every entrepreneur out there.
The name "Factur" comes from the middle of the word Manufacturing, and this industry is one that Gabe not only knows intimately but that he believes strongly in his own team's ability to drive tremendous growth for these entrepreneurs.
Factur helps with business development for manufacturing companies.
They offer:
📈 Lead Generation
📲 Outsourced Business Development
💲 Marketing Services
👨💼 Industrial Sales Recruiting
Every once and a while I like to deviate from the insurance-focused subject matter and offer up something more universal.
In this episode you will hear about entrepreneurship, faith, manufacturing challenges, how fracking works, dreaming big, building a company that outlasts yourself, growth, optimism, and more!
Chapters:
0:00 Intro to Gabe
5:40 The Family Business
9:54 The Collapse
16:24 Rebuilding From Scratch
23:11 What is "Factur"?
32:26 Thriving During Covid
37:12 Building a 100-Year Company
42:15 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Josh Sullivan is a Territory Manager for Morgan White Group, which creates and delivers innovative insurance products to the marketplace. Even though they have a full suite of solutions, for today's episode, we specifically focused on their Gap Supplemental Health Plan called the "Premium Saver Plan".I have always been intrigued by the financials of a Gap Health Plan, which aims to lower the overall cost of an employer-sponsored health plan by providing a way to bridge the "gap" between the first dollar and the employee's deductible.If an employer raises their employee's major medical out-of-pocket costs, the premiums will go down as a result. "The Premium Saver uses the money saved to fill in the out-of-pocket expense which brings the group’s plan back to its current plan design."This type of product does have some detractors in our industry, so it was great to be able to address those with Josh and hear his perspective.Gap Supplemental medical plans really only make sense when a group is in a fully insured arrangement, and those that are more averse to setting up a plan this way might argue that a group is better off (at least financially) by moving to a self-funded plan.Like every insurance product, each individual employer and their consultant need to determine what is best for their specific situation.Who knows, a Gap Health Plan might be right for you!https://mwgbrokerservices.com/Chapters:0:00 Intro to Josh9:12 Starting in Life & Disability17:00 What is the Morgan White Group20:41 The Premium Saver31:45 Who are Gap Plans For?39:15 What are the Cons of a Gap Plan?46:00 The Future of Gap Plans50:40 Closing Thoughts--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
There is a better way to construct a healthcare plan, and that is why I had Chris Hamilton, Partner at Hotchkiss Insurance back on the @SelfFunded with Spencer podcast after spending the last episode discussing Sales Best Practices only.
You can view Chris' episode on Sales mastery here - https://www.youtube.com/watch?v=VrdbOgRxYis&t=1205s
Chris came from the finance world before coming to benefits, and what drew him to our industry was that he kept seeing very sophisticated employers with huge healthcare plan spend, continually acting helplessly when it came to their renewals.
Chris couldn't understand why they didn't try harder to save money on their healthcare spend, even when it was the 2nd or 3rd biggest line item on their P/L.
This problem, plus witnessing a personal issue where his brother went bankrupt from out-of-pocket costs from a medical procedure, sent him down the path to being one of the best brokers in the benefits business today.
Key points:
What drew Chris to Employee Benefits
Why Chris Changed His Mind on HSAs
How Employers Can Take Control of Their Plan Spend by Self-Funding
The Best Way for Brokers to Be Compensated
Why we are Going Through a Renaissance in Benefits
What The Benefits Insider Is and Who it Helps
Keywords: self-funded insurance, employee benefits, cost savings, flexibility, risk management, third-party administrator, legal guidance, financial guidance, broker, consultant, advisor, finance
Chapters:
0:00 Intro to Chris
8:35 Entering the Benefits World
14:55 His "Why"
20:10 How Big is the Problem?
26:56 Self-Funding for the Win!
32:25 The Benefits Insider
37:09 The Power of Social Media
41:00 Pros & Cons of HSAs
51:15 A Renaissance in Benefits
54:25 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Entrepreneurship in Autism Therapy - Derek Barrows of Belay On Autism ServicesDerek is the Founder and CEO of Belay On Autism Services, which offers Applied Behavior Analysis (ABA) therapy for children diagnosed with autism in North Texas.In this episode, Derek shares information about applied behavior analysis (ABA) therapy, a widely used approach that focuses on reinforcing positive behaviors and teaching new skills. While ABA has been shown to be effective for many children with autism, it's important to note that it may not be the best fit for every child.In this episode, you'll learn about:👉🏼The potential benefits of play-based therapy👉🏼 The importance of individualized therapy plans👉🏼 Applied behavior analysis (ABA) therapy and how it can be used to help individuals with autismDerek and I have gotten to know each other over the last few years, as our wives are good friends and our daughters participate in your sports together.Derek was diagnosed with dyslexia and ADHD growing up, but never received a diagnosis of autism himself, and we discussed how those challenges played a role in the development of the mission he has with Belay On.For the baseball fans out there, Derek was a very high-level baseball player, spending a few years after college in the minor leagues pursuing a professional baseball career.For those interested in learning more, here is Belay On's website.https://belayonautismservices.com/Chapters:0:00 Intro to Derek9:45 His Healthcare Career13:24 What is Belay On16:35 Autism Diagnosis19:45 ABA Therapy Explained27:04 Derek's Entrepreneurial Journey33:45 Lessons Learned42:34 The Future of Autism Care45:40 Closing Thoughts--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Brian is an AVP of Business Development at Goodroot.
"Goodroot is a community of companies committed to reinventing healthcare one system at a time."
In this episode, we specifically focus on two of the solutions that Brian represents:
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AlignRx, which is their pharmacy consulting arm for larger employers who need individualized expertise for their unique situations.
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CoeoRx, which has prenegotiated Pharmacy benefit contracts and custom pharmacy benefit solutions for employers that offers "choice, leverage, and savings".
Interestingly, Brian has a condition known as hemophilia, a medical condition in which the blood's ability to clot is severely reduced, causing the sufferer to bleed severely from even a slight injury.
Anyone who operates in the world of self-funding knows how expensive this condition can be to an employer, but it was incredibly interesting to hear the human side directly from Brian.
The crux of this episode focused on the world of PBMs, where we discuss everything from PBM contracts, to spread pricing, price transparency, claims repricing, specialty medications, and so much more!
Chapters:
1:25 Getting to Know Brian
8:45 Life as a Hemophiliac
19:00 What is Goodroot
27:20 Sifting Through the PBM Noise
34:45 PBM Best Practices for Employers
39:52 What Data is Required
44:13 Specialty Meds
48:25 Alternate Sourcing of Meds
54:29 Pharmacogenomics
58:30 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
How to Become Unstoppable in SaaS with TK KaderTK Kader is my latest guest on the @SelfFunded with Spencer podcast, where we discussed his successful track record as a SaaS entrepreneur, his company called "Unstoppable" where he helps other early-stage SaaS business owners scale their companies, as well as the outstanding YouTube channel that has over 36k+ subscribers, 1M+ views, 100k+ hours of watch time.TK is also an incredibly cool and down-to-earth guy, even gracious enough to come on my show after a cold outreach by me!Being that my company Plansight is in the SaaS space, and also that TK is a master of using video content for lead generation, I knew he would make an outstanding guest on my podcast.From his website bio:"TK Kader is an entrepreneur, international best-selling author, and also an angel investor. TK worked at Bridgewater Associates (one of the best hedge funds in the world). He then founded ToutApp (backed by Andreessen Horowitz and Jackson Square, two of the best venture capital firms in the world). TK sold ToutApp to Marketo (then owned by Vista Equity Partners, one of the best private equity firms in the world) and was part of the executive team at Marketo that helped drive its transformation and eventual $4.75bn sale to Adobe. TK now leads the Unstoppable movement to help SaaS Founders build & scale incredible software companies."Links:TK's youtube channel - https://www.youtube.com/channel/UCUseoG3kofRLS6WoUaL_15wTK's Unstoppable website - https://www.tkkader.com/TK's book - https://www.amazon.com/How-Punch-Sunday-Jitters-Face/dp/B0BF2TNGG2Episode Highlights:0:00 Intro to TK Kader2:00 His first Company - "My P.I.M.P."9:30 Joining Ray Dalio's Hedge Fund - Bridgewater12:12 Building & Selling ToutApp19:52 Becoming Unstoppable28:30 3 Pillar for Go-to-Market Strategy34:40 Time Management38:22 Your 5-Year Vision41:45 YouTube for Sales Leads50:15 The Future of Unstoppable--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
I sat down with the CEO and Founder, Priscilla Romans to discuss the origin story of Graith Care, and how they are fighting every single day on behalf of Americans to ensure they are getting the best possible care for their unique situation.
Patient Advocacy is all about empowering patients to regain control of their healthcare decisions. When they have informed consent, and are presented with all of their options, the patient should ultimately be able to make the decision that is best for them.
"Graith Care’s mission is to bring back control and transparency to the consumer.
Graith Care breaks down healthcare barriers and provides a holistic view of the patient journey. This care model ultimately improves outcomes and efficiency along with saving time and money.
As your Independent Patient Advocate, we provide medical advocacy, consultation, advice and recommendations in US and Internationally."
Chapters:
0:00 Intro
2:57 Who is Priscilla Romans
11:30 Graith Care Origin Story
17:40 What is "Patient Advocacy"
22:00 How Graith Care Works
31:28 The Story of "Molly & Jim"
37:30 Going Viral on Tik Tok
43:05 The Future of Advocacy
49:00 Closing Thoughts
--- Support this podcast: https://anchor.fm/spencer-harlan-smith/support
A Fiduciary's Guide to Data Analytics with Agility Innovation Partners.
This episode is a follow-up to my video "The Consolidated Appropriations Act 101 - Comply or Die?"
The Consolidated Appropriations Act, otherwise known as the CAA, established protections for consumers related to surprise billing and transparency in health care. Upcoming fines can and will be heavy, amounting to $100/day PER EMPLOYEE, which is substantially greater than the fines hospitals receiving for being non-compliant, which was only $300 total day.
In this Episode - Part 2 - we focus on an employer's fiduciary responsibility now that they have access to claims and pricing data due to the CAA regulation, and the power of using an innovative Data Analytics platform to make sense of it.
Agility Innovation Partners helps offer a data analytics platform with "at-scale pricing" to small-to-mid-market brokers who may not have the leverage on their own. They also offer consulting after the decision to purchase a data analytics platform called Innovu, so that consultants can make sure they maximize the ROI on their investment. Innovu also offers a CAA fiduciary tool stack with benchmarking against 4 million lives for plan design, claims cost, plan design etc, so that an employer can determine if they are paying reasonable cost for care and are compliant. If not, now they know and can take action!
Here is a recent article covering the CAA in greater detail, and outlining the employer obligation to be compliant. Hat's off to Dave Chase, co-founder and CEO of Health Rosetta for bringing it to my attention!
https://docket.acc.com/erisa-covered-companies-must-disclose-health-plan-costs
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
The Consolidated Appropriations Act 101 - Comply or Die?
The Consolidated Appropriations Act, otherwise known as the CAA, established protections for consumers related to surprise billing and transparency in health care.
Upcoming fines can and will be heavy, amounting to $100/day PER EMPLOYEE, which is substantially greater than the fines hospitals receiving for being non-compliant, which was only $300 total day. The goal for employers immediately is not to be perfect by 12/27/22, but to at least show that they made a good faith effort to be compliant.
The price transparency component is where the opportunity lies for employee benefits brokers and their employers to uncover the source of their high cost claims, and then take appropriate fiduciary responsibility in order to pay more appropriate unit costs for healthcare. While there is a cost associated with ensuring you are compliant, the opportunity to retain and win new business for consultants is massive.
Right now, opaque network contracts make it difficult for healthcare consumers to know the cost of care prior to receiving it, and it is nearly impossible to make an informed decision as a patient. The CAA will have a dramatic impact on Americans' ability to price shop on where to go for care, as well as their ability to plan for their out of pocket expense(s).
The goal of the CAA is simple: People should be able to know the price ahead of time, shop using that price as well as quality of care metrics, and then they shouldn't be slapped with a giant, surprise balance bill afterward. At the end of the day, the goal is to allow people to have the tools to shop for healthcare the way that they do so for any other product or service.
Here is a recent article covering the CAA in greater detail, and outlining the employer obligation to be compliant. Hat's off to Dave Chase, co-founder and CEO of Health Rosetta for bringing it to my attention!
https://docket.acc.com/erisa-covered-companies-must-disclose-health-plan-costs
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Sarah is the Founder and CEO of Predictabill, a company that allows you to "compare the health insurance you have with what you could get, and see what’s different since last year." With Predictabill you can analyze options from your employer (including COBRA), your spouse’s employer, healthcare.gov, and more.
Sarah spent 8 years in investment banking, and her area of expertise during this time was evaluating the impact that an organization's insurance expenses had on the valuation of the business.
She jokes that insurance company is "a pile of cash and a bunch of promises", and I am not sure I have heard a better definition than that!
A personal experience with high deductible health plans soon after moving to New York on her own, where she was hit with a $400 out of pocket expense she didn't expect, led to an epiphany about the complexity of health insurance plan design that ultimately sent her down the path of creating Predictabill.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Cariloop provides coaching and support for the caregiver.
Cariloop has been recently recognized as number 40 in the "Dallas 100", which means they are the 40th fastest growing company in Dallas/Fort Worth!
In this episode, I sat down with their co-founder and CEO, Michael Walsh to learn more about Cariloop, as well as to hear his personal story of entrepreneurship.
The Cariloop tagline is "take care of your loved ones with an experienced Care Coach in your corner." and they consider themselves the "World's First Human-Powered Caregiver Support Platform"
Anyone who has ever found themselves tasked with taking care of a loved one, be it an ailing parent, or a child that needs continual mental or physical care, knows just how emotionally difficult that role can be.
Cariloop seeks to provide coaching and support for anyone who finds themselves in that position.
Whether you need logistical support to coordinate care, assistance navigating the complex healthcare world, or simply just someone to talk to, Cariloop is there to help.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Sales Mastery - Part 3 - Ryan Miller - Sales Performance Coach
Ryan Miller is a highly sought after sales performance coach, and I am grateful that he helped me close out the 3-part miniseries of my podcast on "Sales Mastery"
Ryan started off selling high-end wheels/rims for custom cars, and didn't discover the world of benefits until later in life. He also has overcome numerous personal challenges, from having a strained relationship with his father, developing bad habits in his teens and 20's that nearly lead to jail time, and even being present with his wife at the infamous Las Vegas mass shooting where a bullet went straight through his wife's trucker hat without hitting her!
Ryan eventually found his way to God, was able to salvage a marriage on the brinks, and to eventually building a successful sales and performance coaching business infused with his faith in Christ.
He is a master of real authenticity, and this episode is absolutely loaded with great advice.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Chris Hamilton is a Partner at Hotchkiss Insurance. He is also one of the best sales consultants I have met in the employee benefits industry, for which many of his peers agree.
Chris, like me, didn't get into sales until his 30's, having spent the bulk of his career before that in investment banking. His ability to discuss financials, coupled with his experience in Mergers and Acquisitions, helped prepare Chris to have very complex conversations with business owners.
Chris is the antithesis of your "stereotypical" salesperson. He doesn't speak so fast you can't follow his words. He doesn't use sales tricks or focus on always closing the deal. He simple brings expertise, along with a deep level of integrity, to his prospects to build rapport and trust.
In short, Chris is a modern benefits consultant, and our entire industry could learn from the example he has set!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Sales Mastery - Part 1 - Jennifer Bryson - Mercer
This is the first installment of a 3-part series dedicated to sales mastery.
Not only is Jennifer Bryson an absolutely lovely human being, she is always a killer producer!
She had a career-defining year in 2021 for Mercer and we talked about everything from how she builds long standing relationships, to her keen recognition of when to pull in other rockstars on her team to help solve big problems for her clients.
Although Jennifer and my next two guests come from the employee benefits industry, each of the 3 conversations is focused on universal sales best practices.
Enjoy
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Paul Carter is the Chairman/CFO of HMA. Hawaii Mainland Administrators (HMA) is a full service TPA that seeks to be one of the premier managed healthcare organizations in the country through technology and information-based managed care. We covered a ton of info in an hour, and this episode will be especially for my self-funded gurus out there.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
The Metaverse for Business with John Beaman of the Elevare Club.
In this episode we cover the Elevare Club, the Metaverse, digital transformation, digital real estate, the blockchain, NFT's and more!
John not only has a undergraduate degree and an MBA, but he is also certified in something called "Digital Transformation". What that means is he can help small business owners digitize their business, moving from the analog world of paper documents and wet signatures, into the digital world of websites, computerization, machine learning, and having a presence in the Metaverse.
His business, Elevare Club, specifically helps SMB's build out their backend processes and take many of the operational tasks of the owner's plate. They help with putting together a business plan, a marketing strategy, and hone in on their product-market fit.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Your Network is Your Net Worth - Scott Smith - TRUE Network Advisors. I took the podcast on the road to Guntersville, Alabama, home of Scott Smith and his company - TRUE Network Advisors. TRUE is a coalition of employee benefits brokers, seeking to enhance their network and collaborate with other strategic benefits advisors to grow their practices. TRUE is unique in that they have created an extraordinary engaging member experience, with both virtual and in-person events that are all the buzz in the benefits industry. On this podcast, Scott shares his personal story, how he grew up incredibly poor, and used a thirst for reading and knowledge to leverage his way out to a better life. Scott is now a highly sought after thought leader, a hilarious comedy skit writer, and one of the kindest people in our industry. Enjoy!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
NavMD is a Data Analytics Platform for Brokers in the Employee Benefits space. Glenn Fisher is the Managing Partner of NavMD and acquired the company back in 2018. He is also one of the flat out coolest guys I know!
Glenn is also a serial entrepreneur, having built businesses in the waste management space, FinTech, and now in Data Analytics at NavMD.
The focus of episode 62 is the power of having a data analytics platform for your employers. If you want to know what is driving your claims costs up, ultimately causing your premiums to increase every year, you have to know the source of those claims.
NavMD helps consultants uncover this information for their clients, using proprietary methods to identify "episodes of care", which expose opportunities for savings. NavMD can also produce risk scores for employers, to assist stop loss carriers with underwriting the risk.
https://navmd.com/
Chapters:
0:00 Intro Hook
0:37 Hello to Glenn Fisher
1:30 Glenn's Backstory
2:06 The Marine Corps
4:30 Waste Management
10:25 The Shift to Fintech
17:35 Acquiring NavMD
21:15 What is NavMD Data Analytics
35:50 The Future of Data
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Can you warranty spine surgery? Jamie Rindler, CEO of Marvel Group believes you can, and that is exactly what his company does! Marvel Group offers a Surgical Outcome Warranty for Spine patients. The warranty itself is actually supported by the medical device manufacturer, which augments their own product warranty. In exchange, the device providers get data in return that helps them improve their products, and understand what is, and is not, working. The revolutionary part is that the benefit of the warranty actually goes to the patient themselves. The Marvel Group actually sees a surgical revision rate of only 3%, which is well below a rough average of 7-10% revision rate industry wide. They accomplish this by having higher quality surgeons in their stewardship program, best in class devices, and their data collection program that acts as a feedback mechanism for the surgeon. https://marvelgp.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Modernizing Benefits Consulting at Genesys Health, with Chief Strategy Officer Matt Monahan.
Genesys puts a large emphasis on Population Health Management in their practice, helping members navigate their healthcare journey with actionable data, guidance, and support.
Matt has an extensive background from the carrier world with Aetna, having spent a 12 year period as a large group rep. He started at GE/Genworth as a group rep as well, after a short period of time playing semi-pro rugby.
Matt brought that expertise, as well as a tenure at Namely on the technology side of insurance to Genesys, where he gets to apply his diverse skillet into the benefits consulting world.
https://www.genesys.health/
Chapters:
00:00 Intro Hook
00:23 Podcast Opening Credits
00:33 Hello to Matt Monahan
04:50 Matt's Rugby Background
08:40 Matt's Early Career
15:25 Career at Aetna
20:00 Genesis of Genesys Health
28:57 Changing Employee Behavior
37:55 Approach to Consulting
41:20 The Genesys Brand
49:06 Future of Care
51:40 Closing Thoughts
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
What is a High Performance Healthcare Network, and how does it improve the quality of care, while delivering lower costs?
Blake is a native Texan, with a history of working on the "supply-side" of healthcare within hospital systems.
This gives him a unique perspective on the problem of controlling the costs of healthcare delivery. Blake spent time in the Navy, with his inspiration to enlist coming as a result of 9/11.
EHN's purpose is to "Provide quality health benefits for your employees while controlling costs, for them and for your business. With a thoughtful and well executed strategy, these are very achievable goals."
https://www.employershealthnetwork.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Emergency Medical Transport 101.
Everything you need to know about Emergency Medical Transportation, and how MASA MTS is helping control the insanely high cost of ground, and air transportation.
Will Winters is Vice President, Broker and Strategic Partnership Sales, and is also an ex-Emergency Medical Technician (EMT). He learned a lot on the job as an EMT, was exposed to some very traumatic events, and ultimately decided he was better suited outside of the system selling a solution to employers to help control their employees high out of pocket costs.
Also, we kick off the podcast talking about Will bowling a 300 more than once!
"MASA Global provides its members with two distinct benefits -- a membership program that includes the most comprehensive ground, helicopter and fixed-wing ambulance transportation solutions whether at home or abroad and protection from the financial catastrophes that unexpected medical transportation costs will cause. Without rival in the industry, MASA Global prides itself on solving its members' medical transportation needs by "Any Ground. Any Air. Anywhere."
https://www.masamts.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
How CBD Works with the CEO of CORGANICS, Chad Collins. Have you ever wondered about CBD? What is it? How does it work? Is it actually real, or placebo? Then this is the episode for you! I sat down with Chad for Episode 57 to discuss his Company called CORGANICS, and how they are "bridging the gap between healthcare professionals and their patients when it comes to understanding and treating the endocannabinoid system." Chad referenced a 2019 Gallup poll, that showed 1 in 5 Americans was taking some form of CBD. In the same survey, 3 in 5 adults said they felt like it was valid medical therapy. The main reason, he suggests, that a person would cross over from one of those 3 in 5 Americans, to the 1 in 5 taking it, would be recommendation from a medical professional. CORGANICS "provides health care professionals with safe, high-quality CBD products that are developed with the patient in mind. They utilize the latest science-backed methods to create broad spectrum, THC-free CBD formulations and invest in ongoing research into the potential benefits of clinical CBD." https://corganics.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
The Modern TPA - Tech when you need it, people when you don't.
In episode 56 of Self-Funded with Spencer, I sit down with the CEO of HealthSmart, Craig Julien. Craig is a fascinating person, being an avid Triathlete, Mountain Climber, and a World Record Skydiver, while also running a very successful Third Party Administrator.
Throughout his career, Craig has always been willing to raise his hand to take on more responsibility, or a new opportunity, even moving to India for a few years to run a company.
I have sat down with numerous Founders and CEO's, and Craig's story is right up there with the best of them.
0:00 Intro Clip
0:33 Opening Credits
0:41 Craig's Backstory & Career
8:45 Sponsors
9:35 Triathlons, Mountain Climbing & Skydiving
18:30 What is a TPA
24:16 Applying Tech to the TPA world
28:02 Tech + People = Enablement
31:55 Direct Primary Care/Virtual Primary Care
36:52 The HealthSmart Solution
43:55 TPA Trends
47:00 Behavioral Economics
52:04 Big Picture Healthcare Trends
58:00 Closing Thoughts from Craig
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
There are people that have dreams. There are people that execute dreams that other people have. Few people get to do both. Those people are entrepreneurs. That’s the core message that Seth Denson, Head of Benefits for Acrisure, delivered on Episode 55 of the “Self-Funded with Spencer” podcast. In this episode we discussed his successful journey as an entrepreneur, as well as his second career as a business analyst for some of the largest news outlets in America. I’m grateful to call Seth a friend, and honored to feature his story on my podcast.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Jared Pope is the Founder of Work Shield, and a self-described "recovering attorney" to discuss the origins of his company and the solution they provide.
Recognizing the gross inefficiencies in the way companies currently handle internal misconduct, Jared recognized an opportunity to deliver a better dispute resolution service, that was unbiased, faster, and easier to implement than most "Check-the-box" options on the market today.
Work Shield is on a mission to change the way organizations and their people view misconduct
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
The Power of SimplePay Health, a discussion with Wally Gomaa, Co-Founder.
Wally has an extensive track record of success in the healthcare and employee benefits industries, and his latest venture - SimplePay - is an exciting new solution to help bring "Price Certainty" to the health insurance world.
SimplePay Health - Where happy and health plan live together.
https://www.simplepayhealth.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
John shares his own experience with Burnout at 41, which nearly cost him his life, and we discuss the challenges that men have in discussing their mental health with others, even with the typical EAP offerings most employers provide their employees today. It is even harder for people like John, who had been a pastor at a church for his whole career up that point, and who was perceived as a community leader, to express feelings of fear, weakness, emotional pain, etc. because of concerns of how his peers would perceive his vulnerability. This is one of the most important conversations I have ever had on the podcast, and I hope it helps foster meaningful discussions about mental health in men.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Jake Thompson started Compete Every Day as an inspirational apparel company, and over the course of a decade, has grown it into a vehicle for performance coaching, business consulting, and traveling the country to do public speaking. The mindset of getting 1% better every day, while viewed on a micro scale may not seem much, but the aggregate effect over time on your life will have a massive impact. Whether it is your health, your job, your relationships, focusing on the little things you can do every day, adds up. Jake is highly sought after for his ability to effectively communicate this message through the lens of athletics, and apply that mindset to any business to help their personnel leverage their competitive spirit to become happier, and more productive employees. https://www.competeeveryday.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Chas Fields is Senior Partner at UKG - Ultimate Kronos Group - and is also a fellow podcaster, a public speaker, a change management expert, a volunteer, and a baseball coach. Oh yeah, he's also a really cool dude! This episode covers what Human Capital Management is, how it works, and how technology is enabling companies to better manager their Human Capital. We cover topics like the merger of two giant organizations into an even bigger one, managing people through the pandemic, fatherhood, how to be a good person in general, and the future of HCM. Enjoy!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Insurance Captives & Innovation in Healthcare with David Voorhees, CEO of True Captive Insurance.
Insurance captives have been covered quite a bit on my podcast because: 1) They are perceived to be more complex (they're really not) 2) They are an interesting vehicle for smaller employers to successfully transition into being self-funded.
David Voorhees sat down with me after the True Captive St Louis Summit, to discuss the motivations for the creation of True Captive Insurance, why they decided to take risk on every group that joins their captive, and how they are partnering with other innovative solution providers to create best-in-breed options for small to mid-sized employers.
David also talks about how fear often drives the avoidance of innovation, especially for insurance brokers who at times have the misconception that they are obligated to be experts in everything. He argues that NOT knowing something is good, as it should stimulate curiosity and a continual quest for knowledge, and I tend to agree.
David is one of the most consistently eloquent speakers I have had the joy to sit down with, and it is an honor to be affiliated with him through these conferences, and the sponsorship of my podcast. Enjoy!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
How Jumbo Employers are Solving Healthcare.
This podcast focuses on the Health Transformation Alliance (HTA) - A Co-Op - that is fully owned by about 65 Jumbo employers, whose entire mission is to create superior outcomes for their health plan.
Their goals are to save lives, and save dollars.
These employer groups need to have about 5,000 lives on their health plan and pay $500k to join, and all own an equal equity stake in the Co-Op. This fee can be paid over time and can come out of your health budget since it is an ERISA-approved expense.
By joining, these jumbo employers get access to the HTA teams, resources, and the opportunity to collaborate with the other members of the Co-Op
There are certain outcomes that jumbo employers can achieve in healthcare due to their scale and aggregated buying power, which Lee discusses on the podcast.
There are also things that Jumbo employers CANNOT do, that a smaller employer can, and we make sure to focus on some of those solutions as well.
Enjoy!
https://www.htahealth.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
What is it like to work for a TPA? Owen Paradis of JP Farley joins me on the podcast for a discussion on how he got into the insurance world after working as a Corrections Officer. Like most of us, he didn't intend to get into insurance, but has nonetheless found a home here and embraced the learning curve with open arms. Half of the battle is just learning the acronyms, and Owen even said he used my Stop Loss with Spencer videos to help him learn the industry lingo. Owen talks about how much he has enjoyed the TPA space so far, and judging by the brief time I had with him, I believe he will have a tremendously successful career in Employee Benefits!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Have you ever wondered how to plan a conference?
Tonya Crawford of True Captive Insurance sits down with me to share what it takes to put together a major event.
The main thing she said is that planning a conference starts with having great partners. Not just from a sponsorship perspective, but to provide support, as well as help market the event.
It typically would take 2-3 months to plan an event, but Tonya and True Captive were able to pull off a great event in St Louis within 6 weeks.
The event in St Louis was absolutely top notch, with outstanding presenters, great attendees, and very useful information being freely shared to better educate the market at large. In my opinion, that is the way it should be!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Everything you need to know about Insurance Captives, featuring Stephani Manning of Innovative Captive Strategies. We discuss the Layers of Captive, how those layers interact, and which parties are responsible for each of the three layers of the captive. Stephani is a teacher by nature, and it really comes across in how simply she explains how captives work.
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Have you ever wondered what it is like to MC (host) a big conference?
In this episode of "Self-Funded with Spencer" on the road in St Louis at the True Captive Symposium, I discussed this topic with the host of the event - Kiera Hanselman. Kiera started to MC events during the pandemic at virtual conferences, and did such a good job that she kept getting asked to do it again.
She talks about how her theater training helped her prepare to be on stage, but it really comes down to understanding the conference dynamics, getting to know the organization putting the event on, as well as identifying what topics will resonate with that specific audience.
Kiera did an incredible job at the event, and I am sure you will see her on stage hosting an Employee Benefits conference near you soon.
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How Fasting Can Change Your Life.
What is Fasting? What are the benefits of Fasting? How does a beginner get started Fasting? What is the difference in Fasting and Intermittent Fasting? What is Autophagy? What is a Water Fast? What is a Fasting Mimicking Diet?.
Mark Testa is an expert at Fasting, as well as an expert in Stem Cells. Mark has personally gone through multiple 5-day fasts, and is a regular intermittent faster like myself.
Personally, Intermittent Fasting has helped stabilize my energy levels, provided mental clarity, helped with weight management as I approach 40, made "Dieting" simpler, and has been the single best tool I have applied to optimize my life. I hope this episode helps you start your fasting or intermittent fasting journey.
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The "PBM Princess" joins me again on Self-Funded with Spencer on the road, this time in St. Louis at the most recent True Captive Summit, held at Busch Stadium.
In this mini-episode, Rachel highlights the convoluted supply chain in Pharmacy Benefit Management. So many different entities have a hand in the Rx supply chain, from payers, wholesalers, contracts with PBM's, marketing firms, insurance companies, etc, which makes it very difficult to uncover why prescription drug trends continue to increase at a rapid rate.
This had led to further scrutiny of PBMs, especially with the question "How does my PBM get paid"?
Thank you again to David Voorhees of True Captive for inviting me to this industry-leading event to deliver my podcast on the road.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Your own Stem Cells can be extracted from your bone marrow, concentrated, and then later injected into certain areas to potentially eliminate the need for surgery. Many people just refer to it as "stem cells", but bone marrow concentrate which contains stem cells is the most accurate way to describe what Regenexx does. Regenexx can help self-funded employers who have employees which knee injuries, shoulder injuries, back injuries etc. as a possible intermediate step before the last hope is surgery. Mark is a chiropractor by trade, and became aware of how this concentrate containing stem cells could help with many musculoskeletal injuries that normally would require surgery in traditional Western medical practice. They have a very high success rate with certain MSK ailments, and some of the latest research even shows how bone marrow concentrate which contains stem cells can help regrow an ACL if torn less than 1 cm apart! There are limits to its abilities to resolve certain injuries, with the hip joint being one of the least likely locations of the body to positively respond to this bone marrow concentrate. Make sure to check out part 2 where Mark and I discuss all of the benefits of Fasting! To learn more check out https://regenexx.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
What is it like to be a Serial Entrepreneur? When you hear Mark's story it becomes clear that it takes someone with a combination of drive, intelligence, will, luck, faith, and a sense of humor! Mark Combs started his career in financial planning, moved into the employee benefits broker world, helped grow an agency into a successful acquisition, and after experiencing nothing but success in his work life thus far, that is when he said, "everything STOPPED working"! He talks about having to re-invent himself, work through those early challenges, and really struggle until he found the right business model.
Mark is also a genius marketer, so if you are interested in watching his insurance reporting commercial that has over 330k views and was referenced in my intro, watch it here:
https://www.youtube.com/watch?v=om0YjZGVBEI
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Private Equity Explained What is it? How does it work? How do you get a job in private equity? When do you use equity vs debt? What types of firms should go public rather than stay private? What are the stages of growth that impact capital requirements?
All of these questions and more are answered in Episode 44 of "Self-Funded with Spencer", featuring Kyle Coots, Co-Founder & Managing Director of Miramar Equity Partners.
Kyle and I have known each other for almost 30 years, and we reconnected after he was vetting an investment opportunity for his Private Equity firm in the self-funded space. As you can see from this episode, he is an absolutely wealth of knowledge in this space, and even breaks it down at a level that a beginner can understand.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Life Rewards Effort. Randy & I discussed Leadership, Faith, Family, Personal Growth, Managing Career Success, Being a Star Hurdler in High School, Moving from CA to TX, Advice for Young Salespeople, and the roles both of our Wives have played in making us the men we are today. From a random meeting at a children's play-place called "Cheeky Monkey" two years ago during the pandemic, to having Randy sit down this week for the podcast, it has been an interesting two years for both of us.
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“Never Pay the First Bill” This is the title of Marshall Allen’s extraordinary book, which empowers working Americans to fight back against unfair medical billing practices and WIN.
Marshall came on Self-Funded with Spencer to discuss:
✍️ His investigative journalism career
📚 His Substack newsletter
📽 His upcoming video series
👨⚖️ How to win in small claims court
🏥 His son’s recent ER visit
⛪️ His faith and time in ministry
🏛 His new job in the federal gov
📕 and of course, the book!
“Never Pay the First Bill” is a must for the tens of millions of Americans struggling to figure out why their medical care costs so much.
It’s not just healthcare #inflation. There’s also rampant fraud, waste, abuse, up-coding, and even billing for services NOT rendered.
Marshall is educating David on how to fight Goliath, and WIN. It’s time for us to pick that fight!
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Allergy season, muscle cars, space shuttle launches...and Dependent Eligibility Audits?
Keith Bird, VP of Sales for AmWINS came on the Self-Funded with Spencer Podcast to discuss the fiduciary responsibility that Self-Funded Employers have to ensure the dependents enrolled on their health plan are eligible to be there.
Unless you have a good way of validating the eligibility of enrollees manually (you probably don't) then you likely have dependents on your plan today that are not supposed to be there.
Keith estimates that about 3% of dependents on average on any given plan are not eligible. Whether it is a person enrolled as a spouse when they actually aren't married, or an enrolled child on the plan that turns out to be a cousin, the cost of healthcare is so great that many people find the need to defraud their employers for coverage.
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Captives, keynote speaking, employee education, client testimonials, problem-solving, and having skin in the game with your customers, were a few of the many topics Robert Gelb, David Voorhees and I discussed during the final installment of the Self-Funded w/Spencer podcast on the road at the True Captive conference. Here is the registration link for the next Future of Benefits in Business conference in St. Louis, MO at Busch Stadium on 4/12/22. https://truecaptive.com/st-louis-registration/ https://truecaptive.com/ https://www.valenzhealth.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
How much does surgery cost? How good is my surgeon? Sanjay Prasad MD sits down with me to discuss the answers to both of those questions and more.
Sanjay is an Ear, Nose, and Throat surgeon by trade, the Author of "Resetting Healthcare", and the founder of SurgiQuality.
Sanjay is a brilliant man on a mission to create more transparency for patients around the ability of their surgeon, and the price the member will pay.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
"Healthcare is Fixed" - That is the message Glenn Fisher, serial entrepreneur and Managing Partner of NavMD, is delivering to the employee benefits world. We talk data analytics, acting on these insights, FinTech, and why Glenn was attracted to the Healthcare space initially. Beyond the technical nature of his business, he stresses the importance of delivering value to your customer no matter what you do. We round out the discussion on pharmacy, consulting, reference based pricing, captives, and how the Shine Solar testimonial was one of the key takeaways of the conference for Glenn. Here is the registration link for the next Future of Benefits in Business conference in St. Louis, MO at Busch Stadium on 4/12/22. https://truecaptive.com/st-louis-registration/ https://www.navmd.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Rachel Strauss joined me in OKC to discuss the vital role of a transparent PBM, such as her employer EHIM. She has been a previous podcast guest (Episode 10), and she is one of the most knowledge people when it comes to Pharmacy Benefit Management.
She implores employers to ask the simple question, "How does my PBM get paid"?
Rachel also relates the problem of "rebates", to getting money back on your tax return. Is it really better to overpay, and then wait 12 months to get money back?
She sees the market is now more open to change, and the "No Surprises" act is a step in the right direction towards more transparency in the healthcare marketplace.
Hope you enjoy!
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Modern marketing is evolving, and Trey Hinson of Ocozzio shares everything you need to know about this changing landscape.
We covered an array of topics from Self-Funding, Bourbon, LinkedIn Sponsored Posts, The Power of Video for Marketing, Personalized Prospecting, the Decentralization of Healthcare Solutions, Storytelling, and so much more!
This was one of the most difficult episodes to edit because there was so much great content. I ended up making 4 promo clips instead of 1!
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In installment 3 of my coverage of the True Captive Summit, I sit down with the CEO of Vālenz®, Robert Gelb.
"Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement".
Rob is quickly becoming one of my favorite people in Employee Benefits because of his charisma, his focus on company culture, and the "yes, and" mentality he brought over from studying improv to apply to the business he runs.
In this episode we cover, keynote speaking, overcoming travel issues, music as an aid in preparation, passion for what you do, and ultimately how to deliver best in class benefit design and selection.
https://www.valenzhealth.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
In installment 2 of my coverage of the True Captive Summit, I sit down with Adam Berkowitz of Simpara, and his client Lance Young, of Shine Solar.
In this mini-episode, we discuss Lance's experience working in Human Resources and how his partnership with Simpara inspired Shine Solar to transition from fully-insured to self-funded.
Shine Solar went from experiencing annual costs increases with no ability to counteract this trend, to lowering their cost multiple years in a row, while simultaneously improving their benefits for their employees!
I LOVE client testimonials, so thank you so much to Lance and Adam in sharing their success story!
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Episode 38 of Self-Funded with Spencer features Jorge Arzate, CEO and Founder of MAKINA BENEFITS.
Jorge joined me on the show to discuss the role of a boutique-style independent TPA and his passion for helping small employers take control of their healthcare spend.
We had conversations about discipline as an entrepreneur, focusing on growth over just setting goals, and even kicked the chat off with our mutual upbringing on #heavymetal.
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I recently took the Self-Funded w/ Spencer Podcast on the road to Oklahoma City where I covered the Future of Business and Benefits Conference, Hosted by True Captive Insurance and Presented by Valenz. In this mini-episode, I sat down with the CEO of True Captive, David Vorhees, to discuss the goals for the conference and what the audience should expect in terms of quality content.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Dan is the US Head of Sales, Middle Market for Meritain Health.
He has an extensive career in Employee Benefits, especially in Self-Funding, and received his CEBS designation through an affiliation with the Wharton School.
In particular, this episode focuses on the advanced role of a TPA for self-funded groups, and how they can serve as an open architecture solution for employers to customize their health plan and better control the cost of care.
Dan is also an avid fitness enthusiast, participating in triathlons as well as competitive rowing, and this passion for his own personal health coincides perfectly with his career.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
One of the most neglected parts of our healthcare system in the last few years has been the lack of availability in virtual mental/behavioral health support for employees.
In this episode, Mike Kohl of Vida Health joined me to discuss whole person healthcare, which includes a heavy emphasis on getting members of an employer sponsored health plan access to mental health support as quickly as possible.
Mike is a great person, with an awesome story, and I hope you find this information valuable.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Erik Templin is Executive Vice President at Brown & Brown.
He is one of the most knowledgeable people in our industry, and the person responsible for introducing me to the concept of self-funding.
He's also an outstanding strategist, salesman, and family man, and has been a mentor for me as I go through my own career journey in this industry.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Allison is the Founder of Altiqe Consulting, a boutique employee benefits consulting firm out of San Antonio, Texas.
Allison is easily one of the most innovative EB consultants I know, and also a podcast host herself, with her show called "Raising the Bar with Allison De Paoli".
https://raisingthebar.live/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Chris Fisher is the Founder of BenefitsAlly and the creator of the 3x3x3 podcast series.
Chris has alway had a finger on the pulse of what’s new and innovative in the insurance space, and he’s one of the most connected people I know in employee benefits.
We discuss everything from new benefit solutions, carrier group school, Vonlane luxury bus travel, and Chris’ COVID hair!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Megan Chiarello and Andy Neary join me in the studio to discuss how to maximize your efforts on LinkedIn.
If you are a salesperson, an entrepreneur, a marketing specialist, and insurance broker, or just someone that wants to grow your network of prospects and clients, this special episode of the podcast is for you!
Make sure you follow all of us on LinkedIn for more great content!
Megan Chiarello - https://www.linkedin.com/in/meganchiarello/
Andy Neary - https://www.linkedin.com/in/andyneary/
Spencer Smith - https://www.linkedin.com/in/spencer-smith-self-funded/
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Chetara Brisbon is the Director of Growth for Nice Healthcare.
Chetara flew all the way in from South Carolina to share her story, as well as her company’s value proposition.
In the show we talk family, her pursuit of a PhD, in-home healthcare visits, virtual primary care services, and so much more.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Reid Rasmussen came on the show to discuss the origins of freshbenies, what it was like moving from Canada to the US and how our healthcare systems differ, as well as his own original employee benefits show "Brokers in Cars Getting Coffee.
freshbenies website - https://www.freshbenies.com/
Brokers in Cars Getting Coffee - https://www.youtube.com/watch?v=0X1umyPQ0QA&t=19s
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
"Captives" Part-2 with David Voorhees, CEO of True Captive Insurance.
David stopped by Frisco, TX on his way back to Kansas City and graciously helped me complete the second part of the #captive podcast miniseries.
He brings a unique perspective having spent the majority of his career in recruiting and human resources, and his captive model has a very employee-centric approach to risk management.
David was also the person who recommended I pitch Waterloo Sparkling Water on a podcast sponsorship, so hopefully we will see some movement on that front soon!
https://truecaptive.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Phil is the Chief Operating Officer of Complete Captive Management Services. He entered the captive world more In 2010, after his 25 years as a Paramedic actually brought him into this world accidentally.
Phil was one of the early warriors out there telling the story of Employee Benefits Captives long before they became as popular as they are today.
This episode is Part 1 of a 2-Part miniseries on Captives, and Phil spends a big chunk of this podcast explaining what Captives are, as well as defining a lot of jargon that surrounds this funding mechanism.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Geniece is a Principal at EPIC Insurance Brokers, and has spent her entire year in the employee benefits and consulting space.
In this episode, we discussed her perspective on self-funding, as well as her interest in cryptocurrency, nomad capitalism, and her love for music as a choir director at her church.
Enjoy!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Preston was recommended separately to me by two industry peers, so I anticipated that it would be an exciting conversation, and he certainly didn’t disappoint.
Not only is he an expert in Employee Benefits & Underwriting, but Preston also used to moonlight as a youth soccer coach for many years and has a son that’s pretty decent at the game ⚽️.
He even gave me a few pointers as a newbie soccer coach, the most important of which was don’t put “Coach Spencer” on the back of your shirt. (Too late)
Enjoy!
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Vince is VP of Sales at Partners MGU, a stop loss managing general underwriter with a unique business model that allows their clients an opportunity to financially benefit from the sale of the company in the future. Vince came on the show to discuss his upbringing in Detroit as the son of a Tailor, his accidental career move into insurance underwriting, and his eventual progression into Stop Loss Sales. Vince is a wealth knowledge, a kind man, and as you can see, a very sharp dresser as well.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Matt shares his journey from being an All-American Golfer at the University of Texas, to spending 5 years as a professional golfer, to eventually finding his passion in the insurance world as a Benefits Consultant.
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Dwight Mankin is the President of WebTPA, a third party administrator with the tagline "We Do Weird" because they focus on large group self-funded clients that want to build a customized health plans for their unique needs.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Colin is a Senior Advisors of Employee Benefits, with over two decades of experience. He takes a technical approach to self-funded, with a degree in Management Information Systems, and he really has a strong finger on the pulse of where the industry is going.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
The product of two parents who were medical doctors, Will knew his future didn’t lie specifically in medicine, but rather found himself consumed by fixing the broken insurance payment model. With successful ventures in payroll, and FSA/HSA/Cobra administration, he’s now set his sights on lobbying for Direct Primary Care with the Employer Coalition for Direct Care.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Chris Wilson is Executive Vice President of Business Development for Healthcare Highways - a "health plan built on by a high-performance network that delivers quality care, cost savings, and sustainable value."
They are aiming to drive down cost and increase quality of outcomes simultaneously by delivering a tailored healthcare network to suit the specific needs of self-funded employers.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Benjamin Prinzing is the Founder & CEO of Rover Analytics, a company on a mission to help small group employers get access to claims data by scraping member EOB's (Explanation of Benefits).
Ben is a serial entrepreneur and started his journey in the healthcare and wellness world over a decade ago, motivated by the passing of a young friend due to a potentially preventable heart condition.
There is no question that Rover Analytics is making waves in the self-funded world!
https://roveranalytics.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
TJ Hutchings is the Manager Director of Employee Benefits for Higginbotham in Fort Worth, Texas.
He's one of the absolute best people I know in the insurance industry, and he came on to share his journey into benefits, as well as a very moving story about overcoming a rare form of childhood cancer called "Ewing Sarcoma".
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Megan Chiarello is Vice President of Marketing for WellNet Healthcare, who provides turnkey level-funded and self-funded solutions to small and mid-market companies.
Megan brings a fresh voice and interesting perspective to a more traditional and slow-moving industry, and she is helping spread the word about a great solution for employers who are typically underserved because of their size.
It is one thing to explain the technicals about a product or solution, and it is another thing to be able to tell the story effectively so that your buyers actually understand what it does, and that is what she does extremely well. She helps "product-tize" the solution!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Today, Mike is a Benefits Consultant with Hotchkiss Insurance, but long before that, he had an incredible journey as a troubled teen, then becoming a Youth Pastor for about 15 years, then turning his sights to the private sector to succeed as one of the top sales people in the entire country at a well-known mattress firm.
Then, he took his biggest gamble of all, putting his full faith in God to move his whole family to Texas, not knowing where they would live or where he would work. He just knew they had to come here, and the rest, as they say, is history!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Anthony Russo is an Executive Regional Manager for Voya Financial, and has spent his entire carrier working on the carrier side of the insurance world.
Anthony has a wealth of knowledge to share about the value of a partnership with a large, director writer of stop loss like Voya, and he also came on to discuss the upcoming large prescription drugs making waves that employers need to be aware of.
Last but not least, Anthony was the first person to give me a shot selling stop loss, and I will be forever grateful in him giving me a chance!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Dan Labroad is the founder and CEO of Ovation Health and Life Services, a full service insurance consulting firm, with a specialty in self-funding. Dan is also a serial entrepreneur with a long track record of building successful business, and he bought and sold his first company (a paper route) at 13! Check out his company here - https://ovationlife.com/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
This episode features Patrick Martell of ClaimDOC. Patrick came on the show to discuss one of my favorite topics - Reference Based Pricing (RBP)! I love the potential of RBP to reduce plan spend, but I am no expert, so I asked Patrick to come to tell us the who, what, why, when, where, and how of moving your self-funded plan to this type of claims payment methodology.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Andy Near is an ex-professional baseball player, who channeled his playing experience into a successful insurance career, before finding his real calling - becoming a high performance coach for Insurance Producers.
Beyond that, Andy is an excellent storyteller and a strong advocate for utilizing content creation to build your personal brand and attract prospect's attention. Website - https://andyneary.com/Podcasts - https://andyneary.com/bullpen-sessions-podcast/
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
In this Episode, Craig Clemente, President & COO of Specialty Care Management (SCM), came on the show to discuss the growing problem of Outpatient Dialysis, and how his organization specializes in controlling the cost of this treatment for self-funded employers.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Rachel Strauss is Director of Strategic Development at EHIM, "national, privately held, woman-owned (WBENC) Pharmacy Benefit Manager (PBM) and Third-Party Administrator that helps organizations proactively contain rising prescription and healthcare costs."
Rachel joined me on the show to discuss the role of a PBM, the hidden costs and dark money in this space, as well as EHIM's approach to doing business the right way.
She also was the person who recommended to me the Magic Merlin Sleep Suit, so if you have an infant at home that is transitioning out of being swaddled, I cannot recommend the Sleep Suit to you enough : )
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
In this episode, Seth Denson, Co-Founder and CSO of GDP Advisors joined me on the podcast to help explain Insurance Captives. Seth talks about the right size group, the appropriate risk profile to join a captive, as well as the technical mechanics of how they work.
In addition to GDP Advisors, Seth is authored the book "The Cure: A Blueprint for Solving America’s Healthcare Crisis", available where all books are sold. Seth is a regular contributor as a market analyst for Fox News, CNN, OANN, NewsMax and Cheddar, and is one of the most sought after commentators on the healthcare industry.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Jonathan Lopez, Ed.D - aka "Dr. J-Lo" joins me on this episode to cover the role of the Third Party Administrator from a different perspective than covered previously. He views the role of the TPA as the "Adjudicator", and explains what he means using a sweet "John Wick" analogy!
Jonathan has an interesting story, having gotten his undergrad degree in Kinesiology, then attending OCS with the Marine Corps, before going back to complete his Doctorate in Education Leadership. Oh, and he also used to own a Crossfit Gym!
Not the typical path towards being an RVP of sales for a TPA...but that is the beauty of the insurance industry. There is no correct path to get in, and once you are in, you can find what interests you to carve out your own path.
Correction - 78% of hospitalizations due to Covid were overweight/obese - not 94%. The 94% statistic was in reference to the percentage of Covid deaths that had comorbidities".
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Yo, what up gang, Spencer here…
Thanks for checking out “Self-Funded with Spencer”, a podcast that seeks to educate around, and advocate for, the self-funded health insurance marketplace.
It has been said that the best defense against tyranny is a well-armed populace, and my goal is to arm you with information to defend against the tyranny of being fully insured!
I appreciate you stopping by. Be sure to subscribe. And I’ll talk to you soon!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Episode 7 of "Self-Funded w/ Spencer" with the hardest working person in employee benefits - Lester J. Morales, Founder and CEO of Next Impact!
Lester is seemingly everywhere these days, both literally and virtually, as one of the most sought after and knowledgeable consultants in the self-funded space. His passion, insight, and enthusiasm are infectious, and it was a pleasure to get to spend an hour with him to hear his story.
Lester joined me on the podcast specifically to discuss the role of a General Agent (GA), and how their responsibility has morphed over time.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
We have approached self-funding from many different insurance industry angles so far, but the most crucial vantage point is discussed in this episode with Tommy Fulmer - The EMPLOYER's perspective.
Tommy is responsible for accounting and finance at The Delta Companies, who has been self-funded since 2012. He discusses his experience budgeting for monthly claims fluctuations, projecting future plan costs, and the decision-making balance that has to be struck between finance and HR.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Courtney is a Sales Executive with ZERO, which focuses on reducing claims costs to a self-funded plan by directly contracting with providers and paying for procedures with predetermined, agreed-upon pricing bundles.
An added benefit, and also where they got their name, is if a member of a health plan uses a contracted provider, they experience zero out of pocket costs themselves.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
4 episodes in and I finally got to talk some stop loss again!
Jeff Petty is the President of PACE Underwriters, a Dallas-based Managing General Underwriter (MGU ) of Stop Loss Insurance. He joined me to discuss what an MGU does, and what specific role they play in the broader marketplace.
Jeff has spent his entire career around stop loss, and is one of the few people that actually has an Insurance degree.
He is also as big of Tool fan as I am, which may be the only topic I like to discuss more than Stop Loss!
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
Come for education on the Healthcare Navigation industry, and stay for a discussion on Alpacas!
Dr. Eric Bricker is a physician, built a successful healthcare navigation company, and is the founder of AHealthcareZ, which focuses on creating education content around the healthcare industry.
He has also written a book called "Healthcare Money Campfire Stories", and has his own podcast titled "How to Sell in Healthcare". In short, Dr. Bricker is one of the most accomplished and passionate voices in the Healthcare space, and it was a pleasure to have him on the podcast!
For my info about Dr. Bricker, see below.
Website - https://www.ahealthcarez.com/
Youtube Channel - https://www.youtube.com/channel/UC8Hr...
Book - https://www.amazon.com/Healthcare-Mon...
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
In this episode we begin to drill down into the self-funded conversation to look at the individual moving parts.
Today's component is the Third Party Administrator, also known as a "TPA".
Jennifer Morgan of Collective Health joined me to discuss what a TPA is, and the pivotal role they play in coordinating a self-funded health plan.
Jennifer brings a wealth of brokerage knowledge to the table as well.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support
This is the inaugural episode of Self-Funded with Spencer, where I am joined by the Practice Leader at Roach Howard Smith Barton (RHSB) Insurance, Dennis Fowler.
Dennis helped me define Self-Funded for this and future episodes, and brings a decade of experience as a broker/consultant in the employee benefits space. We discussed a wide range of topics around self-funding strategies, misconceptions in this space, as well as what he believes the future holds for our industry.
Support this podcast: https://anchor.fm/spencer-harlan-smith/support