Self-Funded

By Spencer SmithBusiness

Self-Funded episodes

April 30, 2024 Can Market-Based Pricing Save Healthcare? (with Dr. Keith Smith)
“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
1 hr 8 min
April 23, 2024 From "Sickcare" to "Healthcare": The Future Of This Industry (with John Butler)
"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
59 min
April 16, 2024 Modern Virtual Care With AI (with Chris Mathew)
"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 Mathew
The 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 Mathew
00:08:09 Entrepreneurial Success Through Resilience and Perseverance
00:14:20 Student Debt Impact on Physicians
00:18:42 Real-time Savings with Sniffle Rx Platform
00:30:05 Seamless Virtual Consultation Experience with Sniffle
00:36:03 Personalized Diet Plans Using AI Technology
00:45:36 Virtual Healthcare Network for Behavioral Wellness
00:57:07 The Future of Sniffle
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 #HealthcareChallenges #AIHealthcare #TelehealthInnovation #VirtualCare #AIIntegration #PrescriptionProcess #BehavioralHealth #EmployeeBenefits #ResilienceInBusiness #ContinuityOfCare #MentalHealthAwareness #selffunded #podcast
Entrepreneurship, 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
1 hr 2 min
April 12, 2024 The MSK Roundtable, with Chris Hamilton, Heidi Ojha, and Mark Testa
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/
1 hr 25 min
April 09, 2024 Why "HR" Became "People" (with Monica Panetta)
"I always knew there was more. I always knew there was a different dimension to what this personnel or HR thing was." - Monica Panetta
Monica Panetta, Chief People Officer at ParetoHealth (a show sponsor and the company I work for), joined me for an evening podcast in studio as we talked all things HR/People, starting with why the industry has moved away from saying HR.
Monica’s so well-versed in the field that she actually started the HR program at her college as she was attending it, and the curriculum is still taught today. We talk how she got started in the field, how the field has evolved post-COVID, and how she made her way to Pareto.
Join us this week to find out a bit about Pareto, and a lot about what it means to be a Chief People Officer.
Chapters:
00:00:00 Meet Monica Panetta
00:01:38 Employee-Centric Leadership: How HR Has Evolved
00:02:38 Transitioning From “HR” to “People”
00:05:00 Getting Started In HR
00:13:16 Monica’s Career Journey
00:21:31 Strategic Benefits Management As An HR Employee
00:23:31 Empowering Employees Through Mental Health Support Programs
00:24:32 Promoting The EAP Program Internally
00:40:13 Recognizing Every Employee’s Journey
00:41:39 Cultural Compatibility Evaluation In The Hiring Process
Key Links for Social:
@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded
Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02
Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286
Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/
Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/
Key Words:
#ChiefPeopleOfficer #HRterminology #CareerExploration #FinancialAcumen #EmployeeAssistancePrograms #UtilizationStrategies #EmployeeExperience #Onboarding #CultureFitAssessment #HRroles #WorkplaceWellness #JobSatisfaction #selffunded #podcast
Chief People Officer, HR terminology, Career Exploration, Financial Acumen, Employee Assistance Programs, Utilization Strategies, Employee Experience, Onboarding, Culture Fit Assessment, HR roles, Workplace Wellness, Job Satisfaction, self funded, podcast
52 min
April 02, 2024 Founding A Healthcare Startup (with Russell Pekala)
"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
1 hr 4 min
March 26, 2024 Actually Making Healthcare Affordable (with Taylor Rogers)
“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
51 min
March 19, 2024 Leveling The Healthcare Playing Field (with Gentry Lynn)
“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
1 hr 8 min
March 12, 2024 Is Ozempic A Sustainable Solution? (with Durrell Finch)
“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
1 hr 18 min
March 05, 2024 How Adapting to Regulations Can Benefit Your Practice (with Jen Berman)
"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
58 min

About Self-Funded

From the publisher's feed

Self-Funded, hosted by Spencer Smith, is the definitive resource for benefits consultants and employers who are ready to challenge the broken healthcare status quo. Each week, you'll get an insider's…