Healthcare on the Rocks - Employee Benefits with a Twist

In this episode, guests Tommy Axford and Dr. Natalya Gertsik from Private Health Management (PHM), talk about clinical trials and cancer care. They discuss why employers struggle with cancer-related costs and how clinical trials can be both medically beneficial and cost-effective. The conversation centers on the unique challenges cancer presents as a complex set of diseases rather than a single condition with standard solutions. Dr. Gertsik highlights a story about "Peter," who was given three months to live but achieved complete remission through a clinical trial identified by PHM. As Peter recounts, "It has now been a dozen years that I have been in remission from what was an original death sentence."

The discussion explores barriers to clinical trial access, including the vast number of trials available and various patient, provider, and institutional challenges. With specialty oncology medications averaging $65,000, clinical trials sponsored by pharmaceutical companies can offer significant cost savings for employers. Dr. Gertsik, "Most of the benefits employers are putting in place work for 95 percent of their population, but they don't work as well for the sickest and most expensive 5%."

Key Takeaways:

• Cancer's complexity requires sophisticated solutions beyond traditional benefits
• Clinical trials can provide cutting-edge treatments while reducing employer costs
• Major access barriers include provider time constraints and complex qualification criteria
• Solutions need to focus on the 5% of employees who represent the highest healthcare costs
• Employers need partners who can address all cancer types comprehensively

Stay in Touch!

• Connect with Tommy Axford and Dr. Natalya Gertsik on LinkedIn
• Visit Private Health Management (PHM)
• Download PHM’s report on clinical trials and cancer 
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources

Connect with our co-hosts Brittany Hardaway and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this insightful episode of "Healthcare on the Rocks: Employee Benefits with a Twist," Lauren Gums, Executive Vice President of Clinic Services at Transcarent, shares her expertise on the rapidly evolving world of telehealth and virtual care. With over 20 years of healthcare leadership experience, Lauren offers valuable perspectives on how these technologies are reshaping consumer expectations and transforming healthcare delivery. 

Throughout the episode, Lauren highlights the growing importance of convenience and accessibility in modern healthcare, noting that "90 percent of the U.S. population [has] smartphones, and of those smartphone users, 96 percent prefer text." She explains how telehealth platforms like Transcarent are meeting these expectations by providing "urgency and accuracy" in care delivery.

The discussion covers a wide range of topics, including the sustainability of virtual care models, the revolutionary role of AI in healthcare, and crucial factors employers should consider when evaluating telehealth programs. Lauren also addresses the critical issues of data security and privacy in virtual care solutions, emphasizing their importance in maintaining trust and compliance.

Key takeaways from the episode include:

• Telehealth usage has stabilized at about 38 percent higher than pre-pandemic levels, indicating a lasting shift in healthcare delivery preferences.
• AI is playing a pivotal role in enhancing personalization, improving diagnostic accuracy, and streamlining care delivery in telehealth.
• When assessing virtual care programs, employers should focus on employee engagement, health outcomes, and overall satisfaction.
• Robust security measures, including HIPAA compliance and AI governance programs, are essential for protecting member data in virtual care platforms.
• Virtual care platforms are seen as complementary to traditional healthcare, with Lauren advocating for "an integrated hybrid approach to delivering care."

Stay in Touch!

• Connect with Lauren Gums on LinkedIn
• Visit Transcarent 
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources
• Connect with our co-hosts Brittany Hardaway and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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Way back in Season 1 of our Healthcare on the Rocks podcast, we talked with Josh Reimer, the Director of Channel Partnerships at Included Health, about many of the challenges of today's healthcare system.  Since then, Included Health has joined the Springbuk Activate Partner Marketplace, which enables Springbuk clients to see how they can improve care outcomes for members with complex specialty conditions. With the help of Included Health, employers with high-cost claimants can lower costs, provide better outcomes, and improve the satisfaction of their members. 

Listen, or perhaps re-listen, to this encore episode while Josh describes how Included Health leverages its data science and clinical expertise, along with a network of 4,000 leading nationwide experts, for a review of a diagnosis or treatment plan recommendation.  I hope you enjoy this special encore episode.

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this episode of "Healthcare on the Rocks: Employee Benefits with a Twist," hosts Brittany Hardaway and David Pittman sit down with Dr. Michael Rees, a kidney transplant surgeon and the founder and CEO of Rejuvenate Kidney Transplant Solutions. Dr. Rees shares his journey into transplant surgery, driven by a desire for innovation and high success rates. He explains the current state of kidney disease treatment in the U.S., highlighting the limitations of dialysis and the superiority of kidney transplants. Dr. Rees paints a stark picture of the risks associated with kidney failure, stating, "Getting a diagnosis of kidney failure is a much worse diagnosis what your chances are of surviving for 5 years than is breast cancer."

The conversation takes an interesting turn as Dr. Rees discusses the barriers to kidney transplantation, including risk aversion in the medical community and financial obstacles for patients. He emphasizes the cost-effectiveness of transplants compared to long-term dialysis, noting that a transplant could save payers "three quarters of a million dollars" over three years. Dr. Rees also shares his frustration with the lack of awareness among healthcare payers about these cost savings, saying, "Payers tend to think that transplant's really expensive." He concludes by highlighting how Rejuvenate Kidney Transplant Solutions is working to educate employers and improve access to transplants.

Key takeaways:

• Kidney transplants are safer and more cost-effective than long-term dialysis
• More than 80% of kidney failure patients in the U.S. die on dialysis without receiving a transplant
• There's a need for better education among healthcare payers about the benefits of kidney transplants
• Innovative solutions, such as covering travel expenses for living donors, could increase transplant rates
• Rejuvenate Kidney Transplant Solutions aims to improve access to transplants and educate employers

Stay in Touch!

• Connect with Dr. Michael Rees on LinkedIn
• Visit Rejuvenate Kidney Transplant Solutions 
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources

Connect with our co-hosts Brittany Hardaway and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this episode of "Healthcare on the Rocks: Employee Benefits with a Twist," hosts David Pittman and Brittany Hardaway sit down with Will Rumsey, Senior Vice President of Sales at Specialty Care Management (SCM). Will shares his journey in the healthcare industry and explains how SCM focuses on risk mitigation in the renal space. He discusses their two main solutions: chronic kidney disease (CKD) management and outpatient dialysis risk mitigation. 

Will emphasizes the prevalence of kidney disease, noting that "90 percent of individuals with kidney disease don't realize they have it," and highlights the demographic disparities, stating, "For every one Caucasian, there can be three African American, Latino, or Hispanic individuals with kidney disease."

The conversation dives into the unique aspects of SCM's approach, including their budget certainty model and focus on member experience. Will explains their cost-saving potential, saying, "We went from having $2.7 million to just over $700,000, saving about 73% off of the paid charges." 

He also discusses their renal risk assessment process, which provides precise data on kidney disease prevalence within a population. Will addresses the challenges in the healthcare market, particularly around data access and scalability. The episode concludes with Will encouraging listeners to reach out for a free renal risk assessment, stating, "Let us do, at no cost, that renal risk assessment exercise and show you what your exposure could be."

Key takeaways:

• SCM offers CKD management and outpatient dialysis risk mitigation solutions
• Their programs can significantly reduce healthcare costs for employers
• Kidney disease is often undiagnosed and has demographic disparities
• SCM's approach provides budget certainty and improved member experience
• Data analytics and proactive strategies are crucial for future cost containment

Stay in Touch!

• Connect with Will Rumsey on LinkedIn
• Visit Specialty Care Management
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources

Connect with our co-hosts Brittany Hardaway and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this episode of "Healthcare on the Rocks: Employee Benefits with a Twist," hosts Nicole Belles and David Pittman sit down with Bill Snyder, CEO of Cylinder, to discuss the growing crisis of gastrointestinal (GI) diseases and their significant impact on the workforce. Bill provides a detailed overview of how Cylinder, a company recently rebranded to reflect its mission of prioritizing gut health, is tackling these issues with innovative and personalized care solutions. The conversation highlights the staggering costs associated with GI diseases, amounting to $136 billion annually, and underscores the importance of preventive care and data-driven strategies for employers.

Bill explains how Cylinder's tech-forward approach, coupled with personalized human touch, offers comprehensive care for GI conditions. The discussion also delves into the broader implications of GI health on overall well-being, touching on correlations with diabetes, cancer, and mental health. Bill's insights into the prevalence of GI conditions, the role of diet, and the benefits of personalized treatment plans provide a compelling narrative on why employers should prioritize GI health solutions. Notable quotes from Bill include, "Digestive health is certainly having a moment," and "We wake up every day with our mission of revolutionizing digital health gut first on our mind."

Key Takeaways:

• GI diseases cost $136 billion annually, more than heart disease or mental health.
• One in four Americans suffer from a chronic GI condition, impacting workplace absenteeism and productivity.
• Cylinder offers a tech-enabled, personalized approach to GI care, integrating dieticians, gastroenterologists, and digital therapeutics.
• Improved GI health can lead to better overall health, reducing costs and improving quality of life.
• Employers see high participation and engagement with Cylinder’s solutions, reporting significant cost savings and improved health outcomes.

Stay in Touch!

• Connect with Bill Snyder on LinkedIn
• Visit Cylinder Health
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources

Connect with our co-hosts Nicole Belles and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this episode of "Healthcare on the Rocks: Employee Benefits with a Twist," hosts Nicole Belles and David Pittman welcome Tom Falvey, co-founder and CEO of NewHealth. With over 20 years of experience in employee benefits consulting, Tom discusses how NewHealth is revolutionizing the patient experience within health insurance. He shares his personal journey into the health insurance industry, influenced by his father, and explains the inspiration behind NewHealth, which aims to bridge the gap between patients and the healthcare system by providing real-time feedback on healthcare experiences. 

Tom details how NewHealth's platform integrates directly with health insurance claims to provide timely patient satisfaction surveys, offering valuable insights to plan sponsors, HR teams, and brokers. This feedback loop helps organizations make informed decisions, balancing cost-saving measures with patient experience. He highlights how NewHealth's unique, claim-verified feedback system offers more accurate and actionable data than other patient satisfaction platforms. Tom also shares success stories and discusses the platform's quest to become the leading patient satisfaction tool in the country.

Key Takeaways:

• Tom Falvey’s Journey: Inspired by his father's career, Tom entered the health insurance industry and eventually co-founded NewHealth to improve patient experiences.
• NewHealth's Mission: The platform collects real-time feedback on healthcare experiences, integrating with insurance claims to provide accurate, actionable data.
• Unique Features: Unlike other platforms, NewHealth offers claim-verified feedback specific to different types of care and diagnosis codes.
• Success Stories: NewHealth has helped organizations make significant cost savings while improving patient satisfaction.
• Future Vision: Tom aims for NewHealth to become the top patient satisfaction platform in the country, focusing on verified and specific feedback.

Notable Quotes:
"If you're going to play this part between a patient and a doctor, we should be in a position to share as much information as we possibly can."

"Our goal is to prepare the plan sponsor and the broker for future decision-making."

Stay in Touch!

• Connect with Tom Falvey on LinkedIn
• Visit NewHealth
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources
• Connect with our co-hosts Nicole Belles and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this episode of "Healthcare on the Rocks: Employee Benefits with a Twist," hosts Nicole Belles and David Pittman sit down with Deb Adler, CEO of Navigator Healthcare. Deb shares her extensive experience in healthcare and her journey in launching Navigator, a company dedicated to providing immediate and effective support for individuals struggling with substance use disorders. 

Deb emphasizes the importance of quick access and engagement in care, describing Navigator's unique approach that includes a 24x7 resource center staffed with licensed clinicians who are trained in motivational interviewing and have deep experience in substance use disorder. She highlights the challenges faced by individuals and their families, noting how Navigator helps them navigate the complex landscape of treatment options, ensuring they receive the right care at the right time.

Deb explains how employers see a significant return on investment, with Navigator's services contributing to a healthier, more productive workforce. Deb recounts a poignant success story of a mother who, during a crisis, was able to quickly get her daughter into a treatment program thanks to Navigator's support. This episode sheds light on the critical role of employer-supported substance use services and the evolving landscape of care.

Key Takeaways:

• Quick Access and Engagement: Navigator provides immediate support with a 24x7x365 resource center and licensed clinicians trained in motivational interviewing.
• Employer Benefits: Navigator offers a significant return on investment and contributes to a healthier, more productive workforce.
• Real-Life Impact: Success stories, like the mother who swiftly got her daughter into treatment, illustrate Navigator's real-world impact.
• Stigma Reduction: Employers play a key role in creating recovery-ready workplaces, reducing stigma, and offering support through confidential services.

Stay in Touch!

• Connect with Deb Adler on LinkedIn
• Visit Navigator Healthcare
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources
• Connect with our co-hosts Nicole Belles and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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In this light-hearted yet informative episode, Chrissy Krampert, Chief Strategy Officer at Jellyvision, shares the fascinating journey of Jellyvision, from its quirky beginnings in educational content and gaming to becoming a leader in healthcare benefits education with ALEX, their flagship product.

She explains how ALEX leverages behavioral science and technology to simplify complex healthcare decisions for employees, turning confusion into clarity. Chrissy highlights how Jellyvision’s tools help employees make smarter healthcare choices, ultimately saving employers significant costs. "We want to go to where there is furrowed brow and bring it to peace of mind," she says, encapsulating their mission.

The discussion delves into the practical impacts of ALEX, from employees proposing to it during open enrollment to Jellyvision’s strategic use of claims data to offer personalized healthcare advice. Chrissy emphasizes the importance of building trust and engaging employees with humor and simplicity. 

The episode also covers Jellyvision’s future plans, including their partnership with Springbuk to enhance data-driven decision-making and the integration of AI for more precise recommendations. "We're able to establish that trust and guide an employee throughout the year to making better decisions," Chrissy notes, showcasing the influence of their innovative solution.

Key Takeaways:

• Behavioral Science: ALEX uses behavioral science to engage employees, helping them understand and utilize their benefits effectively.
• Cost Savings: ALEX helps employers save on healthcare costs by guiding employees to choose and use the best-fit plans.
• Personalization: The integration of claims data and AI allows for tailored healthcare guidance, enhancing the employee experience.
• Engagement and Trust: Jellyvision builds trust through humor, simplicity, and personalized interactions, making healthcare decisions less daunting.

Quotes:
"We want to go to where there is furrowed brow and bring it to peace of mind." - Chrissy Krampert

"People would rather do their taxes while cleaning their bathroom before they'd want to pick a benefits plan."

Stay in Touch!

• Connect with Chrissy Krampert on LinkedIn
• Visit Jellyvision
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources
• Connect with our co-hosts Nicole Belles and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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Dr. Adonis Saremi and Cody Fair from Noom join this to discuss the significant impact of GLP-1 medications on weight management conversations within the employer space. Cody, the Head of Commercial Healthcare at Noom, shares insights into how these medications are elevating the importance of weight management in employer health programs. Dr. Saremi, Noom’s Interim Chief Medical Officer, emphasizes the collaborative effort at Noom in integrating clinical protocols, safety, and quality into their offerings.

Cody highlights the rising interest in GLP-1s, especially, and weight management overall, stressing the need for comprehensive weight management solutions. Dr. Saremi elaborates on the effectiveness of GLP-1s when combined with lifestyle changes, underscoring the importance of adequate support and guidance for patients. The discussion examines the role of employers in ensuring employees receive the necessary medical support and the holistic approach Noom takes in addressing both physical and mental health aspects of obesity care.

Key Takeaways:

• Elevated Importance: GLP-1 medications have propelled weight management to a top concern for employers.
• Comprehensive Support: Effective weight management requires a combination of medication, lifestyle changes, and ongoing support.
• Mental Health Integration: Addressing mental health is crucial in the context of obesity care, with Noom incorporating depression screening and comprehensive medical history assessments.
• Holistic Solutions: Noom aims to provide a seamless integration of weight management solutions within existing employer health benefits, focusing on prevention and chronic disease management.

Stay in Touch!

• Connect with Dr. Adonis Saremi and Cody Fair on LinkedIn
• Visit Noom
• Learn more about the Springbuk Activate Partner Marketplace and get other related resources
• Get the complete 2024 Employee Health Trends report and other related resources

Connect with our co-hosts Nicole Belles and David Pittman 

Have feedback, questions, or suggestions for show ideas? Send them to us at [email protected].

Please rate and review us on your favorite podcast platform, and share it with your friends and colleagues. We appreciate you and thank you for listening!

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