Open Source Health with Tripp Johnson

In this episode, Tripp Johnson and Marcus Shumate discuss the intricate process of scaling a healthcare company while maintaining a strong, patient-centered culture. Tripp shares insights on the role of upward mobility and generational wealth in retaining top talent, and how equity compensation structures are key to attracting the right people. The discussion contrasts healthcare business models with those of tech and venture capital-backed companies, highlighting the importance of aligning incentives for sustainable growth. Tripp also explores the complexities of balancing short-term financial goals with long-term company values, and the need for structural innovation in compensation models to foster growth without compromising patient care.

Key Points:

• Upward Mobility and Generational Wealth: Great companies should enable employees to secure upward mobility and wealth, which is crucial for long-term success and retention.
• Equity and Compensation Structures: Equity compensation becomes a critical tool for attracting and retaining talent, especially in the context of growing companies.
• Balancing Growth with Culture: Scaling a company without sacrificing culture or patient care is a key challenge in healthcare businesses.
• Tech vs. Traditional Models: Unlike traditional businesses, tech companies prioritize growth and market share before profitability, a strategy that could benefit healthcare companies looking to scale.
• Innovative Equity Models: Tripp discusses the need for flexible, performance-based equity structures to align incentives and ensure long-term success.
• Equity Buybacks: Companies must plan for scenarios where executives leave, as this could involve buying back their equity, which presents liquidity challenges for smaller businesses.
• Flexibility in Compensation: The right mix of performance bonuses and equity incentives is essential for attracting the right people and scaling the business effectively.
• Structural Innovation: Beyond technology, companies need structural innovation in how they operate, particularly in terms of compensation and organizational design.
• Long-term Incentive Alignment: Getting the incentives right early on is essential for attracting talent that will drive growth while staying true to the company’s core mission of providing high-quality care.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode, Tripp Johnson and Marcus Shumate delve into the implications of Robert F. Kennedy Jr. (RFK) potentially leading the Department of Health and Human Services. They discuss RFK's controversial views, particularly his criticisms of the pharmaceutical industry and his stances on public health issues like diet and vaccination. The hosts explore the complexities of health discourse in the age of social media, emphasizing the need for nuanced understanding rather than binary thinking. They also address broader societal challenges affecting health, including access to nutritious food and the societal pressures contributing to mental health issues. Ultimately, they advocate for fundamental lifestyle changes and a more realistic approach to health and wellness.

Key Points

• RFK's Leadership Role: The discussion revolves around RFK's appointment to lead the Department of Health and Human Services, highlighting his controversial views on vaccines and the pharmaceutical industry, which can polarize public opinion.
• Nuanced Health Discourse: The hosts criticize the oversimplification of health issues in social media, arguing for a balanced perspective that recognizes both legitimate concerns and the value of established medical advancements.
• Societal Responsibility for Health: They contend that mental health challenges are often rooted in societal issues rather than just individual problems, emphasizing the importance of addressing systemic factors that contribute to anxiety and depression.
• Skepticism Towards Quick Fixes: The podcast critiques the tendency to seek quick health solutions, like trendy diets or supplements, and instead advocates for sustainable lifestyle changes such as proper nutrition and regular exercise.
• Complexity of Nutrition: The conversation includes the challenges of promoting healthy eating in a society where access to nutritious food can be limited, particularly in food deserts, and highlights the need for more equitable food policies.
• Understanding Health Trends: The hosts discuss the importance of being critical consumers of health information, questioning the motives behind health fads and advice, and stressing that all health discussions should consider individual circumstances and scientific validity.
• The Role of Chemicals in Food: They address misconceptions about chemicals in food, arguing that all substances are chemicals and that a focus on "natural" foods can often overlook the importance of balanced nutrition and dietary science.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode, Tripp Johnson and Marcus Shumate walk you through their take on the ongoing challenges faced by healthcare providers in navigating the insurance landscape, particularly with Blue Cross Blue Shield in North Carolina. They discuss the frustrations stemming from delayed payments and administrative hurdles that not only impact their practice but also compromise patient care. Tripp shares insights on the implications of these issues for the broader healthcare system, emphasizing the need for collaboration between providers and insurers to ensure accessible and affordable care. Through candid conversations, the episode sheds light on the complex interplay between healthcare delivery and insurance, advocating for greater accountability and systemic change.

Key Points:

• Delays in Payments from Blue Cross: Tripp Johnson highlights ongoing struggles with Blue Cross Blue Shield, citing significant delays in payment for services rendered. These issues affect cash flow and the overall sustainability of provider organizations, which is crucial for maintaining quality patient care.
• The Impact of Administrative Barriers: The episode discusses the complex administrative requirements imposed by insurers, such as prior authorizations, which can delay access to necessary care. These barriers can lead to worse health outcomes for patients, particularly in behavioral health services.
• The Role of Insurance in Healthcare Affordability: Both hosts emphasize the importance of a collaborative relationship between providers and insurers to create a healthcare system that is not only profitable but also accessible and affordable for patients. They argue that a breakdown in this relationship undermines the foundational goals of the healthcare system.
• Advocacy for Systemic Change: Tripp expresses a desire to engage with policymakers to address the consumer protection issues arising from the monopolistic practices of large insurers like Blue Cross. The conversation underscores the need for transparency and accountability in insurance operations to protect both patients and providers.
• Building a Coalition for Change: The episode concludes with a call to action for listeners to join the effort in advocating for better practices within the insurance industry. Marcus and Tripp encourage collaboration among providers, patients, and advocates to push for necessary reforms in the healthcare system.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode, Tripp Johnson shares his experiences and frustrations as a provider dealing with Blue Cross Blue Shield (BCBS) in North Carolina, particularly regarding their insurance claims processing and payment issues. He emphasizes the importance of being an in-network provider for quality patient care but expresses concern over BCBS's recent changes and practices that have negatively affected payment for services rendered. Johnson discusses specific incidents where payments were delayed or denied, highlighting systemic issues within BCBS. He raises concerns about the potential financial instability of BCBS and its impact on the healthcare landscape in North Carolina.

Key Points

• In-Network Advocacy: Being an in-network provider is morally and strategically beneficial, but it comes with significant administrative challenges.
• Claims Payment Issues: Johnson details a lengthy struggle to receive payments for services provided under BCBS, including a specific incident where $150,000 was held up for over 18 months.
• Complex Taxonomy Changes: Recent changes in BCBS's billing taxonomy created confusion and payment issues for different levels of care (Partial Hospitalization vs. Intensive Outpatient).
• Prior Authorization Delays: There are significant delays in obtaining prior authorizations for treatments, impacting the timely care of patients with substance use disorders.
• Potential Death Spiral: Speculation that BCBS might be facing serious financial challenges due to the loss of a large state health plan contract, leading to potentially unethical practices to conserve cash.
• Need for Complaints: An emphasis on the importance of documenting issues and filing complaints with the Department of Labor and the Department of Insurance to seek resolution.
• Historical Context: A reflection on BCBS's reputation in North Carolina, noting its long-standing role as a trusted insurer and expressing concern over recent changes.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode, hosts Marcus Shumate and Tripp Johnson engage in a thought-provoking discussion about the implications of educational disparities between men and women, the erosion of trust in institutions, and the importance of civic engagement at the local level. They explore how societal values around education affect dating dynamics, particularly for college-educated women seeking partners with similar qualifications. The conversation touches on the skepticism towards public health measures during the COVID-19 pandemic and the growing anti-establishment sentiment, highlighting how these factors contribute to political disenfranchisement among young men. Ultimately, they call for a return to community involvement and a more balanced approach to political discourse, encouraging listeners to engage with local governance.

Distrust in Institutions: Marcus shares observations on the increasing skepticism toward institutions that arose during the COVID-19 pandemic. He points out how public health messages often felt disjointed from reality, leading to a broader distrust of authority figures and established norms.

Civic Engagement and Local Politics: Tripp emphasizes the need for people to engage more in local governance instead of focusing solely on national issues. He argues that understanding and participating in local politics can help address community grievances and rebuild trust in institutions.

The Value of Bureaucracy: Both hosts discuss the essential role of bureaucracies in providing necessary services, such as clean drinking water and food safety. They caution against the anti-establishment sentiment that overlooks the benefits of structured governance and the achievements of society.

Encouragement for Balanced Perspectives: The episode concludes with a call for listeners to lower the temperature of their political discussions. Marcus urges people to disconnect from online outrage and engage meaningfully with their communities, promoting healthier discourse and civic responsibility.

Educational Disparities: Tripp highlights that men are graduating from college at half the rate of women, which affects their attractiveness in the dating market. He discusses how this creates a smaller dating pool for college-educated women who typically seek similarly educated partners.

Impact of Dating Apps: The speakers note that dating algorithms often lead women to prioritize only a small percentage of available men, exacerbating feelings of inadequacy among less favored men. This contributes to a cycle of frustration and alienation for those men.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this enlightening episode, Marcus Shumate sits down with Corey Kennedy to discuss the complexities of postpartum depression and the critical importance of support systems for new parents. Corey candidly shares her personal journey through postpartum challenges, highlighting the lessons learned from her first and second experiences. She emphasizes proactive measures, open communication, and the need for workplaces to better accommodate new parents. The conversation is a heartfelt reminder that it’s okay to seek help and that motherhood, while rewarding, often comes with its own set of difficulties. Join us as we explore how to create a more understanding and supportive environment for all parents.

Key Points:
Corey's Personal Journey: Corey shares her experiences with postpartum depression, detailing the proactive steps she took during her second pregnancy to seek help and support, in contrast to her first experience.

The Importance of Open Communication: Corey emphasizes how discussing her struggles with her husband and support system was crucial for her recovery, allowing her to express her needs and receive the necessary help.

Workplace Education and Support: She advocates for greater awareness among employers about postpartum challenges, stressing the need for flexible work arrangements and gradual transitions back to work to better support new parents.

Normalizing the Challenges of Motherhood: Corey encourages parents to openly discuss the difficulties they face, highlighting the importance of recognizing that both joy and struggle coexist in the journey of motherhood.

Seeking Help as a Sign of Strength: The episode concludes with Corey advising new parents that it’s perfectly okay to ask for help, and that acknowledging the complexities of motherhood is essential for well-being.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode, Marcus Shumate and Tripp Johnson dive deep into the world of insurance billing, focusing on the nuances of in-network and out-of-network practices in behavioral health. Tripp shares his insights from transitioning to in-network provider status, discussing the benefits such as increased patient volume and stabilized revenue streams, while also addressing the complexities and challenges faced during the process.

The conversation covers the different billing models—cash pay, out-of-network, and in-network—highlighting how in-network billing can lead to quicker payments and improved access to care. Tripp reflects on their initial missteps, the importance of renegotiating contracts, and the evolving landscape of healthcare insurance. They also touch on future trends, including the potential for AI-driven solutions to streamline billing processes.

Whether you're a healthcare provider or simply curious about insurance billing, this episode offers valuable insights and practical advice.

Key Points: 

• In-Network vs. Out-of-Network: The episode explains the differences between in-network and out-of-network providers, focusing on contracts with insurance companies and the impact on costs and billing for patients.
• Advantages of In-Network Status: There is a discussion about the benefits for behavioral health providers who are in-network, including increased patient access, higher volumes, and better visibility to clients seeking care.
• Challenges in Contracting: The episode addresses challenges providers face in securing in-network contracts, such as lower reimbursement rates and the time and resources needed for negotiations.
• Strategies for Securing Contracts: Practical strategies for obtaining in-network status are shared, including understanding the contracting process and building relationships with insurance companies.
• Impact of AI and Technology: The role of AI and technology in improving billing practices is explored, highlighting how these tools can streamline claims management and enhance revenue cycle efficiency for providers.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode of Open Source Health, Tripp Johnson and Marcus Shumate dive into the heart of a recent natural disaster that struck Western North Carolina. Marcus shares his firsthand experiences, from evacuating his family and helping neighbors without clean water to delivering essential supplies and organizing grassroots relief efforts. The conversation goes beyond the immediate aftermath of the disaster, exploring the deeper lessons learned about civic duty, community resilience, and the importance of practical action over performative responses. They discuss how empathy can sometimes cloud effective decision-making in a crisis and why basic needs like food, water, and shelter are the first steps to addressing mental health in a disaster scenario.

Key Points:

• Western North Carolina Natural Disaster: Marcus shares the story of how a sudden natural disaster hit Western North Carolina, causing massive flooding, widespread power outages, and infrastructure breakdowns.
• Emergency Response and Rescue: Marcus and Tripp discussed their hands-on response, including evacuating people, delivering emergency supplies, and setting up generators to power wells for clean water in affected areas.
• Leveraging Networks for Fundraising and Resources: AIM (Advaita Integrated Medicine) team and community came together to raise funds and deliver supplies. Marcus reflected on the importance of leveraging personal networks during crises.
• Empathy vs. Utility in Crisis Situations: Marcus highlights the tension between wanting to stay and help versus doing what’s most useful, acknowledging that sometimes leaving to leverage outside resources is more beneficial.
• The Challenge of Information in Crisis: Poor communication and infrastructure breakdowns led to widespread misinformation, which made relief efforts difficult and caused confusion about the accessibility of Western North Carolina.
• Reflections on Civic Duty: Both hosts reflected on the importance of civic duty and the impact of coming together as a community to support each other in times of need.
• Criticism of Performative Actions: They express frustration over performative gestures, like thoughts and prayers or opportunistic marketing from companies during crises, and emphasize the need for genuine, useful action.
• Polarization During Crises: Disappointment was voiced over how political polarization surfaced, with people outside the disaster zone turning the situation into a political issue when, in reality, the community came together across political divides.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode of Open Source Health, Tripp Johnson and Marcus Shumate discuss upcoming changes to Green Hill Transitional Living, exploring a shift from the traditional, transitional living model to a more streamlined, coaching-centric approach. They dive into the challenges of balancing clinical work and day-to-day life coaching while maintaining a patient-centered focus. The discussion also touches on how these changes will lower costs while improving care, emphasizing autonomy and real-world readiness for their clients.

Key Points

• Transition to a Coaching-Centric Model: Green Hill is shifting from traditional transitional living to a coaching-first approach, reducing hand-holding and focusing on empowering individuals for long-term success.
• Cost Reduction and Efficiency: The new model will reduce the monthly cost from $8,000 to $5,000 by eliminating unnecessary activities and staff overlap, while still maintaining high-quality coaching and care.
• Separation of Clinical and Coaching Roles: Clinicians will focus on therapy and mental health management, while recovery coaches will handle day-to-day life skills, goal-setting, and behavioral support.
• Improving Patient Outcomes: By emphasizing autonomy, clients will be responsible for managing their own transportation, appointments, and daily tasks, helping them prepare for real-world challenges.
• Family and Systemic Dynamics: The coaching model addresses the need to separate family anxieties from patient care, allowing both clients and their families to work on their individual challenges.
• Streamlining Operations for Long-Term Sustainability: The shift will allow Green Hill to maintain high-quality services while being financially sustainable, by using data-driven care coordination and focusing on what truly matters for recovery.
• Collaborative Care: Coaches and clinical staff will continue to collaborate on care, but their roles will be clearly defined to avoid overlap, confusion, and inefficiencies.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery

In this episode of Open Source Health, Tripp Johnson and Marcus Shumate discuss the complexities of running digital ads for healthcare services, their decision to bring digital marketing in-house, and how data plays a crucial role in making informed decisions. They explore the challenges they faced in website traffic, working with marketing agencies, and building data-driven policies for caseload management. The episode dives into aligning operations, marketing, and patient care to deliver world-class healthcare efficiently while reducing costs. They also touch on the importance of pricing transparency in the insurance space and future plans to analyze insurance reimbursement rates across the country.

Key Points:

• Challenges in running digital ads for healthcare services.
• Importance of bringing digital marketing in-house to save costs and build internal knowledge.
• Using data to guide marketing strategies and drive website traffic, prospects, and leads.
• Misaligned proposals from agencies vs. internal strategies.
• Caseload management and ensuring patient follow-ups using Power BI reports.
• Setting clear policies for medical visits and follow-up procedures for better patient care.
• Data-driven operational decision-making improves patient care and lowers administrative burden.
• Upcoming transparency in insurance coverage rules and their implications for healthcare providers.

Find us on the web:

• Advaita Integrated Medicine
• Green Hill Recovery