Self-Funded

By Spencer SmithBusiness

Self-Funded episodes

February 27, 2024 The No Surprises Act and Consumer Protection In Healthcare (with Josh Schreiner & Michael Mather)
"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 #podcast
Healthcare, Transparency, Compliance, Innovation, Self Funded, Medical Costs, Consumer Information, Future Of Healthcare, Wearables, Data Driven, No Surprises Act, Regulation, Podcast
1 hr 11 min
February 20, 2024Don't Get Sued: Compliance In The CAA Era (with Sarah Borders)
“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
1 hr 14 min
February 13, 2024 Disrupting The Health Insurance Industry (with Jack Crotty)
"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
43 min
February 06, 2024 How To Build Your Social Media Brand (with Jake Rushton)
"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
1 hr 1 min
January 30, 2024 Closing the Mental Health Gap (with Megan Rozanski)
“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.pdf
Share 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
56 min
January 23, 2024 Direct Primary Care: The Physician Perspective (with Dr. David Cameron)
"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
1 hr 8 min
January 16, 2024 Demanding Healthcare Justice (with Emma Fox)
"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
47 min
January 11, 2024 A Couple On A Healthcare Mission (With David Contorno & Emma Fox)
"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
35 min
January 09, 2024 The Real Cost of Health Insurance (with David Contorno)
"Health insurance has been so perverted that it becomes the one insurance that we go bankrupt when we use." - David Contorno
I 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 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, Wellness Programs, Accurate Diagnoses, Cost Of Health Insurance, Innovative Approaches, Employer Power, Utility Of Networks, Changing Healthcare, Smaller Employers, Self Funded, Health Insurance Podcast
41 min
January 02, 2024 Samaritan Fund - Medical Expense Relief That Changes Lives
"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

59 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…