Self-Funded

In this special episode of Self-Funded with Spencer, I am joined by my friend Seth Denson for my first ever live version of the podcast through LinkedIn Live.

This episode was previously recorded on 12/20/23, but I wanted to make sure that those who missed it on LinkedIn, still had an opportunity to watch and listen.

Seth is the Head of Employee Benefits at Acrisure and he also features daily as a sought after business and market analyst for Fox News, CNN, NewsMax, OANN and more.

In this spirit of an AMA, no question was off limits, so we covered things like:

Our Hair Routines

Social Links:

Self-Funded's Channel - https://www.youtube.com/ @SelfFunded

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Advanced Medical Strategies - Stacy Borans - Founder of AMS

Stacy Borans is a seasoned expert in healthcare technology and data analysis, with a robust background in medical cost management.

As a key player at Advanced Medical Strategies (AMS), she has been instrumental in developing software solutions for payment accuracy, risk assessment, and business intelligence in the healthcare industry. Her perspective on healthcare technology and data analysis in medical cost management is shaped by her experiences at AMS, where she noticed excessively high bills during medical reviews and saw an opportunity to work on the financial aspect of cost management.

Stacy advocates for transparency in chargemaster pricing and cash pricing, and emphasizes the importance of reference-based pricing. She believes that these strategies can help determine the relevant charge for medical services, although she acknowledges that it may not always result in the lowest price.

Join Spencer Smith and Stacy Borans as they delve deeper into this topic on the next episode of the Self Funded podcast.

Chapters:

00:01:08 Creative cocktail concoctions

00:06:46 AMS: Innovating Healthcare Management Solutions

00:10:43 Understanding the Financial Impact of Self Funding

00:16:21 Shaping the Future of Healthcare Cost Containment

00:21:13 Healthcare Solutions for Complex Medical Cases

00:27:24 Catastrophic Diagnoses Cost Projections Software

00:33:09 Comprehensive Risk Assessment and Pricing Tool

00:40:38 Achieving Transparency in Healthcare Decision-Making

00:46:32 Analyzing Group Risk Profiles Using Census Data

00:56:26 The Impact of AI on Healthcare Diagnoses

Key Links for Social

Self-Funded's Channel - 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

Listen on Spotify for Podcasters - https://podcasters.spotify.com/pod/show/spencer-harlan-smith

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words: Medical Strategies, Claims Strategies, Data Analytics, Business Intelligence, Business Intelligence Software, BI Software, Claims Analytics, Insurtech Software, Software for Underwriters, Systems for Carriers, Software for Insurance Carriers, Technology for Insurance, Technology for Insurance Brokers, Tech for Insurance Consultants, Tech for Healthcare, Software for Doctors, Software for Third Party Administrators

Josh Honaker is a seasoned pediatrician from South Central Kentucky, renowned for his expertise in integrating telehealth and education in pediatric healthcare.

He currently serves as the CEO of Parent MD, a platform that embodies his belief in the necessity of Telehealth and education as solutions to common frustrations and disconnects in pediatric healthcare.

Dr. Honaker's perspective is shaped by his experiences with time constraints and high patient volumes, which often leave parents feeling frustrated and uninformed.

He sees Telehealth and education as vital tools to improve healthcare access and provide parents with reliable information and resources. Honaker envisions Parent MD as a platform that unites Telehealth partners, educational content, and a supportive community to enhance the medical home and provide comprehensive care for children.

Join Spencer Smith and Dr. Josh Honaker on this episode of the @SelfFunded with Spencer podcast to delve deeper into this innovative approach to pediatric healthcare.

Key Words: Telehealth, Direct Primary Care, DPC, Pediatrics, Pediatrics Telehealth, Parents, Education for Parents, Community for Parents, Resources for Parents, Employee Benefits for Parents, Healthcare, Employee Benefits, Benefits Brokers, Insurance Brokers, Insurance Consultants, Employer-Sponsored Healthcare, Innovations in Healthcare

Key Links for Social

Self-Funded's Channel - 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

Listen on Spotify for Podcasters - https://podcasters.spotify.com/pod/show/spencer-harlan-smith

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Chapters:

00:00:00 Virtual Pediatrician Partnership for Holistic Childcare

00:03:57 The Impact of Mentorship on Choosing Pediatrics

00:14:56 Entrepreneurial Pediatric Care: A Unique Approach

00:21:44 Virtual consultations for comprehensive pediatric care

00:28:58 "Comprehensive Digital Resource for New Parents"

00:37:39 Expanding direct-to-consumer model to employers

00:43:48 Future plans for personalized nutrition education

00:46:22 Transforming Healthcare Delivery for Cost-Effective Care

00:52:11 Revolutionizing Healthcare with AI

00:56:11 Advancements in healthcare for optimal human health

Recruit & Retain with Employee Benefits - Kyle Minick

The evolving employer market is placing a greater emphasis on HR policies, benefits, and healthcare transparency. In this episode of the podcast "Self Funded" hosted by Spencer Smith and featuring Kyle Minick, the importance of these factors in talent management strategies was discussed.

Traditionally, financial compensation has been the primary focus for employers when it comes to attracting and retaining talent. However, surveys have consistently shown that compensation is not the top priority for employees. Instead, factors such as flexibility and paid time off are often cited as more important. This highlights the need for employers to look beyond monetary rewards and invest in HR policies and benefits that foster a supportive work culture.

Creating a sense of value among employees is crucial for retaining them. This can be achieved through leadership that demonstrates emotional attachment and loyalty. Employees want to feel that their employer cares about their success and well-being. HR policies and fringe benefits play a significant role in creating this sense of value. Offering assistance with buying a home or expanding financial futures are examples of how employers can show their commitment to their employees' long-term well-being.

The insurance industry is also evolving to offer creative and tangible business solutions. Benefits are a major expense for businesses, and insurance companies are recognizing the need to go beyond traditional coverage. They are now focusing on HR policies, fringe benefits, and talent attraction and retention. Summit, a company specializing in benefits, insurance, and investments, is leading the way in serving businesses of all sizes, with a particular interest in blue-collar companies. They are also taking steps to address the high costs of specialty drugs through new pharmacy initiatives.

Chapters:

(00:00:08) Podcasts and Education in Employer Market

(00:01:24) Creating a Culture of Employee Satisfaction

(00:06:05) Creating a Supportive Environment for Employee Retention

(00:10:09) Kyle's Journey in the Insurance Industry

(00:16:00) Innovative Solutions in the Insurance Industry

(00:24:52) Specialized Benefit Solutions for Businesses of All Sizes

(00:30:43) Challenges and Solutions for Blue-Collar Companies

(00:46:26) Pharmacy Initiatives: Addressing Specialty Drug Costs

(00:51:49) Unveiling the Elusive Healthcare Expenses

(00:58:08) Disruptive Innovation for Positive Change

The TPA Problem-Solver - Madeline Smith of MADDRS

Madeline sees her role evolving to focus more on teaching, supporting, and consulting behind the scenes, rather than being at the forefront trying to sell and produce.

She is a strong advocate for challenging the status quo and finding innovative ways to make a difference in the industry. She criticizes the tendency for some in the industry to cut corners and engage in practices that contradict their claims of being different and radical.

Madeline is also the creator of the anthology book - "Whole Lotta $$$ in this MoFo", which is subtitled "An Employer's Guide to Navigating Legalized Larceny Within American Healthcare". I was fortunate to also to a contribute a chapter to this great book.

Buy it here - https://www.amazon.com/Whole-Lotta-this-MoFo-Navigating-ebook/dp/B0BLDMZ3NF

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=687c57dbe9cb4f39

Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Spencer Website - https://spencerharlansmith.com/

Spencer LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Madeline LinkedIn - https://www.linkedin.com/in/madeline-smith-dba/

MADDRS LinkedIn - https://www.linkedin.com/company/maddrs/

From Military Service to Employee Benefits - Two Veterans' Journey into Healthcare

Transitioning from military service to civilian life can be a daunting task for some veterans. However, with the right support and guidance, veterans can find fulfilling careers in various industries.

One such industry is insurance consulting, which offers a unique blend of strategic thinking, problem-solving, and client management. In a recent episode of the podcast @SelfFunded with Spencer, hosted by Spencer Smith and featuring Cliff Favors and Winston Elliott, the topic of veterans transitioning to civilian careers in insurance consulting was explored in depth.

Networking and Support: Key Factors for Success

One of the key takeaways from the episode was the importance of networking and support for veterans transitioning to civilian life. Cliff Favors and Winston Elliott, both veterans themselves and employees at Lockton, emphasized the value of reaching out to others who have already made the transition. They highlighted the Houston veteran community as an excellent resource for connecting with like-minded individuals and gaining insights into different industries.

The Rewards of the Benefits Industry

Despite its reputation as a potentially dull field, the benefits industry, particularly insurance consulting, offers rewarding opportunities for veterans. Cliff Favors mentioned that the benefits industry is often misunderstood and under-appreciated. He emphasized that the industry plays a crucial role in solving people problems rather than just crunching numbers. By focusing on the human aspect of business, insurance consultants can make a positive impact on the lives of employees and their families.

Lockton: A Trusted Partner in Insurance Consulting

Lockton, a privately held insurance broker, stands out as a company that prioritizes its clients' interests. Winston Elliott highlighted the unique advantage of being privately held, as it allows Lockton to focus solely on serving its clients without external pressures from shareholders or private equity firms. The company's commitment to comprehensive support was evident in its approach to medical coding and identifying questionable claims. With a team of medical doctors and coding experts, Lockton goes beyond traditional insurance brokers, acting as trusted advisors to business owners and CFOs.

The People Solutions Approach

Lockton's people solutions approach sets it apart from other insurance brokers. Rather than simply offering cost-saving solutions, Lockton aims to be a trusted advisor to its clients. By addressing not only healthcare concerns but also broader business challenges such as retention, compensation, and leadership development, Lockton positions itself as a strategic partner in the growth and success of its clients' businesses.

Tradeoffs and Challenges

While transitioning to a civilian career in insurance consulting can be rewarding, it is not without its challenges. Spencer Smith, the podcast host, highlighted the need for consultants to be proficient in their subject matter. The complexity of the healthcare industry requires consultants to continuously update their knowledge and skills to provide the best solutions for their clients. Additionally, veterans transitioning to civilian life may face the challenge of translating their military experience into relevant skills for the insurance consulting field. However, with the right support and networking opportunities, these challenges can be overcome.

In conclusion, veterans transitioning to civilian careers in insurance consulting have a unique set of skills and experiences that can be valuable in this field. By leveraging networking opportunities, seeking support from veteran communities, and aligning with companies like Lockton that prioritize client interests and comprehensive support, veterans can find fulfilling careers in insurance consulting.

In this episode of the podcast @SelfFunded with Spencer, hosted by Spencer Smith and featuring Paul Pruitt, the topic of addressing high medication costs in healthcare was discussed. The episode shed light on the challenges faced by individuals and employers due to the financial burden of expensive medications and explored potential solutions to alleviate this issue.

Paul Pruitt, CGO of SHARx, shared his personal experience of spending $1.8M on annually on medication for his family. This staggering amount highlights the significant impact that high medication costs can have on individuals and their loved ones. SHARx aims to address this problem by offering a medication procurement optimization platform that simplifies the process of accessing expensive medications not covered by traditional health insurance.

One of the key factors discussed in the episode is the importance of personalized healthcare. Pharmacogenomics, which involves studying how an individual's genetic makeup affects their response to medications, was highlighted as a potential solution. By understanding a patient's genetic profile, healthcare providers can optimize their treatment plans and avoid prescribing medications that may have negative effects or provide no benefit. This personalized approach can lead to better health outcomes and potentially reduce medication costs.

However, implementing pharmacogenomics in healthcare comes with its own set of challenges. The episode emphasized the need for an appetite for this approach and ensuring that it doesn't compete against other priorities in the healthcare industry. Balancing the adoption of new tech and approaches with existing practices and systems is a tradeoff that needs to be considered.

Another aspect discussed in the episode is the role of patient assistance programs (PAPs) in helping uninsured or underinsured individuals access free or discounted medications. PAPs provide financial assistance to eligible patients, making medications more affordable and accessible. Exploring alternative sources for medications, such as sourcing from countries like Canada where prices are more affordable, was also mentioned as a potential solution.

The episode highlighted the challenges faced by employers in providing affordable healthcare benefits to their employees. The high cost of medication is a pressing issue that affects both employers and employees. Solutions like those offered by SHARx aim to alleviate this burden by providing medications at zero out-of-pocket cost and offering a more sustainable approach to healthcare coverage.

The current healthcare system in the United States was also discussed as a contributing factor to high medication costs. The supply chain from manufacturers to wholesalers, pharmacies, and patients is often manipulated and broken, leading to inflated prices. The pay-to-play mentality and rebates between different players in the supply chain further complicate the issue. Patients rarely benefit from these rebates, and the cost savings are not passed on to them.

In conclusion, addressing high medication costs in healthcare requires a multi-faceted approach. Personalized healthcare through pharmacogenomics, patient assistance programs, and exploring alternative medication sources are potential solutions. However, implementing these solutions comes with challenges and tradeoffs.

Chapters: