In this episode of Impact Healthcare, host Lester Morales dives deep into the world of Reference-Based Pricing (RBP) with Omar Arif, Senior Vice President of Growth at Claim DOC. Together, they explore how RBP is disrupting the health benefits industry by replacing traditional PPO networks with a more transparent, cost-effective approach.

Omar shares real-life examples of how organizations can save millions while improving access to care, debunking myths surrounding RBP and addressing common challenges. Whether you’re an employer, benefits consultant, or healthcare professional, this episode provides actionable insights to rethink your healthcare strategy.

Key Takeaways:

   What is RBP? A simplified breakdown of how RBP determines fair, transparent pricingfor healthcare services.

      Overcoming Misconceptions: Tackling fears and addressing the perceived complexity of adopting RBP.

        The Role of Advocacy: How proactive communication with providers ensures a seamless transition for employees and minimizes disruptions.

      Audit and Fiduciary Responsibility: How Claim DOC’s rigorous auditing process safeguards plan assets andensures fair pricing.

      Real-World Success: A case study highlighting a 41.4% reduction in healthcare costs for a 300-employee agricultural company.

     Employee-Centric Focus: The importance of lowering employee contributions while improving healthcare access.

This episode is a must-listen for anyone seeking innovative solutions to reduce healthcare costs without sacrificing quality.

Connect with Claim DOC:

Visit claimdoc.com, follow them on LinkedIn, or check out theirpodcast, Claim Talk, available on Spotify and YouTube.

Listen now to discover how you can take control of your healthcare costs and create a lasting impact!

On this episode of Impact Healthcare, Lester Morales dives deep into the revolutionary model of Direct Primary Care (DPC) with Dr. Eric Crall, a pioneer in transforming primary care. From the challenges of traditional healthcare to the incredible impact of DPC on employers, employees, and the

Key Takeaways:

Real-Life Impact:

Dr. Crall shares success stories, including a car dealership that saw substantial cost savings while offering better benefits. Employees gained access to care without out-of-pocket expenses, creating a healthier and more engaged workforce.

Who Should Watch?

This Episode?     

Employers looking to cut healthcare costs and attract/retain top talent.

Advisors seeking innovative ways to optimize health plans.

Employees curious about how DPC can revolutionize their healthcare experience.

What You’ll Learn:

Take Action Now: If you're ready to explore DPC for your

Subscribe for More: Stay ahead of the curve with the latest strategies to disrupt the health benefits industry. Hit like, share, and subscribe to Impact Healthcare today!

In this episode of Impact Healthcare, host Lester Morales welcomes Josh Butler, President of Butler Benefits and Consulting and High Plains Health Plan, to discuss the game-changing Texas House Bill 711—the "Tier and Steer Bill."

This new legislation allows self-funded employers to customize health plans and incentivize employees to choose high-quality, lower-cost providers through financial benefits like $0 deductibles and co-pays.

Josh shares how High Plains Health Plan has pioneered this approach, proving that transparent, direct contracting reduces costs while improving care quality.

What is HB 711? Texas is leading the way by legally recognizing tiered healthcare models that reward smarter healthcare choices.

How "Tier and Steer" Works: Employees pay less (or nothing) when they choose high-quality, cost-effective providers in Tier 1 networks.

The Big Insurance Companies’ Role: Why traditional carriers don’t fully adopt these models—premium equals revenue.

Direct Contracting Advantage: How negotiating with hospitals directly results in better deals, without hidden network fees.

Employer Action Steps: Start with a risk assessment, analyze your claims data, and shift to cost-effective healthcare solutions.

Bottom Line: If you’re still managing healthcare benefits the old way, you’re missing out on significant savings and better employee outcomes.

Subscribe now for actionable strategies that lower costs and impact healthcare for the better!

In this episode of Impact Healthcare, host Lester Morales sits down with Phillip Holowka, COO of Complete Captive Management Services, to dive deep into the world of captive insurance. Together, they explore how captives empower employers to take control of their healthcare expenses, build equity, and improve employee benefits.

Phillip shares his journey from EMS to the insurance industry, offering insights into why captives are a game-changer for businesses of all sizes. Whether you're a seasoned CFO or new to the concept, this episode provides a clear roadmap to understanding captives and their potential for revolutionizing your healthcare

Key Takeaways:

Control and Ownership: Learn why owning a captive puts you in charge of your healthcare dollars and policy language.

Actionable

Connect

Subscribe now and join the movement to disrupt the health

🔥 New Episode Alert! 🔥 In this episode of Impact Healthcare, Lester J. Morales sits down with the incredible Jessica Brooks Woods, CEO of the National Association of Benefits and Insurance Professionals. 🏥 Jessica shares her wealth of experience in the healthcare benefits industry, discussing the cutting-edge strategies that are helping employers lower healthcare costs by over 20% while boosting care quality for employees and their families. 💡

🎧 Key Takeaways:

🚀 If you're an employer or in the healthcare industry, this episode is a MUST LISTEN! Discover how Jessica's leadership is driving innovation and changing the game for healthcare benefits. 🎯

👉 Don’t forget to subscribe to Impact Healthcare and stay up-to-date with the latest insights on cutting healthcare costs and improving employee wellness! 💥

In this episode of Impact Healthcare, host Lester Morales sits down with Daniel McCauley, founder of Mac Consulting Group, to discuss how his personal experiences have shaped his passion for transforming healthcare benefits. 🚀 From aerospace engineering and tech to the healthcare benefits industry, Daniel’s journey is unique, but his insights into data transparency, direct contracting, and cash pay models are invaluable for employers and employees alike.

Topics Covered in this Episode:

Guest Spotlight: Daniel McCauley 👨‍💼

Daniel McCauley is the founder of Mac Consulting Group, a firm dedicated to helping businesses take control of their healthcare costs 💼. With a background in aerospace engineering, tech, and insurance, Daniel brings a fresh perspective to the healthcare benefits industry, focusing on real solutions like cash pay options, direct contracting, and data-driven strategies that improve outcomes for everyone involved.

Key Takeaways:

📲 Don't Miss This Episode!

If you’re an employer, HR professional, or someone navigating the complexities of healthcare benefits, this episode is packed with actionable insights that could save you thousands of dollars while offering better care for your employees.

📣 Subscribe to Impact Healthcare for more episodes on how to revolutionize your healthcare benefits 💼, and don’t forget to like 👍, share 📲, and leave a review to help more people find these game-changing strategies!

Timestamps:

In this episode of Impact Healthcare, Lester Morales sits down with Hugh O'Toole, CEO of Innovu, to discuss how data analytics and transparency are reshaping the healthcare benefits industry. Together, they dive into practical strategies that can help employers, advisors, and fiduciaries make smarter decisions, reduce costs, and improve healthcare outcomes.

Hugh shares his journey into the benefits space, from managing school consortiums to optimizing healthcare costs through data-driven solutions. He explains how transparency and fiduciary responsibility empower businesses to lower healthcare expenses without sacrificing quality. Learn how small changes, like J-code analysis, can save millions and improve the lives of employees and their families.

Key Takeaways:

Don't miss out on this insightful conversation that provides actionable steps to reduce your healthcare spend by 20% through total transparency.

Subscribe to Impact Healthcare on iTunes, Spotify, or your favorite podcast platform.

Welcome to the Impact Healthcare Podcast, where we're revolutionizing the health benefits industry with innovative ideas and game-changing strategies! In our latest episode, host Lester J. Morales has an inspiring conversation with Patrick Staunton, a partner in the Employee Benefits Group at Thompson Flanagan. Patrick's journey from starting his career at Cigna to becoming an influential figure at Thompson Flanagan is a testament to his passion for transforming the way private equity firms approach insurance! 

During their conversation, Patrick takes us through the pivotal moments that shaped this transformation, including his personal experience of stepping into the world of private equity and the challenges he faced along the way. 

Patrick shares the story of a company on the brink of a 60% insurance premium increase—an unsustainable burden for the business. Through innovative strategies, including the use of an independent third-party administrator and a transparent PBM, Patrick and his team were able to save the company nearly $1M. The story doesn't end there, as we explore the crucial role of communication and education in ensuring the success of these alternative plans, especially for blue-collar employees! 

Join us as Patrick and Lester break down the complex world of private equity insurance, revealing how Thompson Flanagan’s hands-on approach not only provides value but also empowers employees to take control of their healthcare!  

This episode is packed with insights, real-life examples, and a deep dive into the strategies that make a difference in the lives of employees and the bottom lines of businesses so whether you're in the healthcare industry or simply curious about the intersection of private equity and employee benefits, subscribe to the Impact Healthcare Podcast and don’t miss this transformative episode! 

In this insightful solo episode, Lester Morales addresses

This episode challenges advisors to step out of their

Key Takeaways:

The negative impact of maintaining the status quo in healthbenefits.

How empathy can enhance decision-making in healthcare

Understanding the financial realities of healthcare costs

The importance of exploring and implementing innovative

Real-world examples of successful health benefits

Subscribe to "Impact Healthcare" on iTunes or your

In this solo episode, Lester Morales tackles the theme of

By understanding the real impact of healthcare costs on both organizations and employees, Lester highlights the importance of empathy and proactive decision-making. This episode is divided into two parts: one focused

Lester also shares compelling statistics and personal

Key Takeaways:

The significance of health benefits in employee recruitment and retention.

Common barriers to change and how to overcome them.

The financial and emotional impact of healthcare costs on

Strategies for making informed and empathetic decisions

The role of transparency and innovation in the health

Subscribe to "Impact Healthcare" on your favorite

Be part of the change and help disrupt the health benefits