Self-Funded

Revolutionizing Healthcare Coordination and Advocacy with Curus

Get ready to dive into the world of healthcare benefits and savings with Spencer Smith's Self-Funded podcast, sponsored by Pareto Health.

In this episode, COO Jared Mort from Curus Health shares his expertise on clinical care coordination, or as he refers to it "Care Orchestration", and how to help mid-sized employers reduce their healthcare costs.

Jared also discusses Curus Health's approach to total life concierge services, which assists people with chronic illness and clinical conditions in navigating the healthcare system.

The conversation is both informative and emotional as Jared and Spencer discuss real-life examples of how Curus Health has helped patients get the necessary care they need while maintaining the quality of their life.

Throughout the podcast, Jared emphasizes the importance of coaching patients and encouraging them to be active participants in their care. He discusses the adverse selection and how Curus Health helps reduce costs while mitigating the risk of expensive medical bills.

The podcast also explores the team's approach to managing end-of-life care for patients and their families, even after the contract has expired.

Jared & Spencer also discuss the challenges of marketing healthcare services to employers and brokers. Jared talks about the cultural apathy that has developed as a result of the bureaucracy and the overwhelming nature of the industry.

The hosts emphasize the immense value their services provide to members and the need for more employers to take advantage of them.

If you're interested in learning more about healthcare benefits and saving money on your healthcare costs, then the Self-Funded podcast with Spencer Smith is for you.

Tune in now to learn more!

Timestamps:

[00:03:27] Career in Air Force and Transition to Civilian World

[00:09:11] Fortnite and Curus: Gaming and Healthcare Mix

[00:12:21] Managing Rising Drug Costs in Healthcare

[00:15:25] Curus: Revolutionizing Medical Treatment and Patient Care

[00:18:30] Virtual healthcare coordination and patient empowerment

[00:21:35] Humanity in healthcare

[00:24:37] Importance of Patient Advocacy in Healthcare

[00:27:45] How medical SWAT teams assist with ongoing medical costs

[00:30:32] Marketing Strategies for a Health Product

[00:33:43] Challenges in Healthcare Sector and Innovative Solutions

[00:36:45] Scalability and Solutions for Healthcare Providers

[00:40:02] Curus Health's support for all businesses

Hashtags

#healthbenefits #employeebenefits #healthcare #selffunding #clinicalcarecoorination #airforceveteran #virtualhealthcare #patientadvocacy #medicalcosts #healthoutcomes #healthcareproviders #malpractice #adverseselect #chroniccare #curishealth #paretohealth #podcasts #healthpodcasts #healthcarepodcasts #smallbusinesshealthcare #healthcarecosts #insurance #healthinsurance #virtualcare #virtualmedicine #patientcare

Data Analytics for the Modern Benefits Broker - Mike Pattengale - Springbuk

Looking to learn about the future of data analytics in healthcare? Look no further than Self-Funded with Spencer!

Host Spencer Smith welcomes guest Mike Pattengale from Springbuk to discuss their innovative approach to data analytics and how it helps drive informed decisions.

The two discuss the impact of COVID-19 on the healthcare industry and how data analytics can help employers make better decisions regarding the well-being of their employees.

Mike and Spencer reflect on their experience of navigating the pandemic and the challenges it brought with it, along with its unexpected benefits, such as exploring new avenues like podcasting.

As they transition to talking about healthcare analytics, Mike, emphasizes the platform's ability to collect and normalize data from various sources, highlighting the collaborative nature of Springbuk's platform. They discuss the value of data analytics, how it can be used to make informed decisions, and the importance of sharing data and embracing technology in the consulting industry.

Mike also discusses the capabilities of their system, including the use of artificial intelligence to identify actionable insights and its clinical and financial impact. They also emphasize the importance of an intentional approach to presenting software features to clients to help them focus on the issues that matter most to them.

Overall, the episode provides a wealth of information about the healthcare industry, data analytics, and empowering employers to better manage their claims cost. The hosts and guest make compelling arguments about the benefits of using analytics, embrace of technology, and the importance of forging lasting relationships.

This is an episode you won't want to miss, and it's a fantastic introduction to the world of healthcare analytics.

Tune in to Self-Funded with Spencer and get ready to learn something new!

Timestamps

[00:00:09] Navigating Zoom during the pandemic

[00:03:19] Mike's Career Pivot during COVID

[00:09:47] Mastering sales skills through storytelling and connecting

[00:19:24] The Downside of Entrepreneurship

[00:22:19] Mike's sales career journey

[00:25:25] The Growth and Innovation of Springbuck

[00:28:21] Integrating Data Sources for Health Plan Management

[00:31:42] Turning Data into Action with Springbuck's Solutions

[00:34:53] Data Analysis in Healthcare Spending

[00:38:14] Post-COVID Tech Sales Advancements

[00:41:27] Benefits and Target Market for the Solution

[00:44:44] Data Analytics for Managing Healthcare Costs

[00:47:39] The Future of Data Analytics in Business

[00:51:00] Balancing Technology and Skilled Professionals in the Industry

[00:53:58] AI and Actionable Insights

[00:57:01] Future of Healthcare Data Analytics

[01:00:07] Challenging Industry Status Quo with Younger Workforce

Best Quotes:

"I realized everything that I was confident in and my ability to sell was winning people over in person. And I took every strength that I thought I had and it was removed..."

"Coming out of the pandemic, and when people go back to real world, you'll either become a hunk, a chunk, or a punk..."

[00:05:52] Obviously, brokers need to be talking about this with their employers nowadays, or you're gonna be in a losing position"

#virtualcommunication #COVIDpivot #skillsdevelopment #selfdiscovery #contentcreation #dataanalytics #healthcareplan #employeecare #dataenrichment #technologyinhealthcare #transparency #diverseworkforce #gratitude #podcastguest #musicanddrumming #podcastsponsor #Springbuk

Join host Spencer Smith on another episode of Self-Funded with Spencer, as he welcomes the PBM Princess, Rachel Strauss from EHIM.

In this engaging and informative podcast episode, Rachel shares valuable insights about the Pharmacy Benefits Management industry and EHIM's merger with ProCare Rx. Rachel and Spencer also take a deep dive into the importance of transparency in PBMs and how it affects the relationship between PBM and clients.

Rachel shares her journey of becoming a PBM consultant and how she found her niche as a problem solver, helping clients navigate complex healthcare systems and policies.

This episode discusses PBM selection and highlights the challenges of determining which PBM would work best for your company. Rachel shares her thoughts on a pricing model called "Cost Plus", which Mark Cuban has popularized recently in the world pf Pharmacy Benefit Management.

Additionally, the podcast highlights the need to align PBM incentives to client goals, the importance of understanding client priorities, and writing RFPs that align with them.

In this engaging conversation, Rachel shares her prediction on the reporting mandates that will track dollars and rebates, potentially affecting the earnings of some companies.

Another important aspect of Rachel's work is in fixing problems, rather than just identifying them. She explains that her role is not just about diagnosing issues but providing actionable solutions that can make a difference in the lives of patients and providers. Rachel's work is guided by her passion for improving healthcare access and quality, and she encourages others to find their own purpose and drive in their work.

Don't miss the fun banter between Spencer and Rachel as they share stories, opinions, and experiences. Tune in now for an engaging and informative conversation on pharmacy benefits management, self-funding, and everything in between!

Chapters;

[00:00:00] Introducing "PBM Princess" Rachel Strauss

[00:02:32] PBM Princess's Impact in Sales & EHIM's Merger

[00:05:50] The Rise of Transparent PBMs

[00:08:59] EHIM's Integration into ProCare for Advanced Tech

[00:11:59] Navigating emotional experience of company acquisition

[00:14:46] Navigating the Complex PBM Industry

[00:17:44] Pharmacy Benefit Management complexities and Mark Cuban's involvement

[00:20:26] Spread Pricing in Pharmacy Benefit Industry and Mark Cuban's Launch

[00:23:22] Strategies for Saving Costs in PBM Industry

[00:26:14] PBM Tactics and Rebates Issues

[00:29:05] The Deceptive Nature of Pharmaceutical Rebates

[00:32:04] EHIM's formulary strategy and committed rebate transparency

[00:35:00] Private Equity in PBMs

[00:40:37] Turning Healthcare Data into Actionable Insights

[00:43:30] Customized Services for Diverse Client Goals

[00:46:30] Third-party Vendor Blacklisting and PBM Priorities

[00:49:30] Debate on Ozempic coverage for weight loss

[00:52:27] Insurance Coverage of Bariatric Surgery

[00:55:19] Creativity and Collaboration in PBM

#PBMs #pharmacybenefits #consultants #EHIM #ProCareRx #specialtydrugs #transparency #rebates #formulary #privateequity #dataanalytics #medicalcompliance #Ozempic #obesity #bariatricsurgery #creativity #partnerships #healthcareindustry #podcasts #podcastingtips #podcastingcommunity #businessstrategies #salesindustry #employersponsoredplans #specialtypharmacy #pharmacycosts

How Artificial Intelligence is Powering the Future of Risk with Matt Weaver of Gradient AI

Gradient AI helps underwriters make better assessments of risk, especially when limited loss and claims history exists, or even in the potential absence of claims data altogether.

This solution can be helpful in the world of self-funding when it comes to underwriting stop-loss insurance, especially for smaller employers.

Matt, who brings his expertise in the legal and sales domains, shares his experience working at large insurance defense firms after law school, selling insurance despite no prior knowledge of the industry, and eventually finding himself working with Gradient AI.

He explains how the Gradient AI tool uses advanced data analytics and Artificial Intelligence to accurately assess risk profiles for small and mid-sized business groups.

Their platform has revolutionized the underwriting process, making it faster, and much more efficient. They also discuss the challenges of predicting outcomes for the "messy middle" groups and how the pricing model can lead to a rollercoaster ride for employers.

Listeners will learn the importance of data to support the recommendation of self-funding and how Gradient AI is using AI to make more informed decisions in the insurance industry.

Join Spencer and guest Matt Weaver, as they share their insights into how AI is changing the future of employee benefits and A and H space.

Timestamps

[00:00:09] Artificial Intelligence in Self-Funding Underwriting Tools

[00:03:04] Experience working at an insurance defense firm

[00:06:06] Transitioning from Insurance Defense to Benefits Consulting

[00:09:01] Starting in Insurance Sales

[00:14:42] Transitioning from traditional brokering to consulting

[00:17:53] From PEO Consulting to Joining Gradient AI

[00:21:04] Gradient AI's Role in Predicting Risk for Insurance

[00:27:37] Challenges in Underwriting Self-Funded Businesses

[00:30:45] Distinguishing Factors in Predictive Analytics

[00:37:14] Risk Scores and Cost Estimates for Health Insurance

[00:40:30] Success of Data-Driven Underwriting Tool

[00:43:35] Revolutionizing Underwriting in Insurance Industry

[00:46:33] Innovative Pricing Model & AI in Health Benefits

[00:52:56] The Power of Claims Data in Insurance Consulting

[00:55:47] Maximizing Benefits of Self-funded Healthcare Plans

[00:59:02] Challenges of Self-Funding for Employers

[01:01:59] Procurement processes for clients and use of data

[01:05:26] The Future of Artificial Intelligence in Insurance

[01:11:47] Risk Analytics and Artificial Intelligence in Insurance

Ross Conner, CIC, CRM is a Partner at Hotchkiss Insurance in Fort Worth, TX, where he focuses on helping middle market and franchise businesses grow through a compliant, consistent, and streamlined risk management program.

Oh, and Ross is in Property and Casualty, not Employee Benefits. Now you might ask what is a P&C guy doing on a self-funded benefits podcast?!
Well besides being hilarious (follow him on LinkedIn here ----> https://www.linkedin.com/in/ross-conner-cic-crm-9b1189a/ ) and having a truly remarkable life story, Ross also created a unique insurance captive to help manage risk at a very large children’s activity franchise.

Ross started his career as a general contractor building high-end homes, but an unfortunate downturn in the economy coupled with being overleveraged with inventory he couldn't sell ultimately led him down the path of bankruptcy.

Ross was then in a position where he had to reinvent himself and eventually found his way into the world of insurance.

In this episode, Ross emphasizes the power of Networking.

He says networking played a crucial role in helping him turn his career around and how your network can create opportunities, generate leads, and open doors that can help you grow your business.

Here are three tips to make the most of your network:

1. Attend events and conferences: One of the best ways to meet like-minded people and expand your network is by attending industry-specific events and conferences. These events bring together professionals from different backgrounds who share similar interests and can create opportunities for business collaborations.

2. Build genuine relationships: It's important to approach networking as an opportunity to build relationships rather than simply sell yourself or your business. Take the time to listen to others, understand their needs, and offer support and assistance where possible.

3. Follow-up: After connecting with someone, take the initiative to follow up with them. Send an email or set up a phone call to check in and keep the lines of communication open.

This is a great episode for anyone who likes risk management, property and casualty discussions, insurance captives, personal growth, and a great redemption story!

#contentcreation #insuranceindustry #careerjourney #entrepreneur #finance

ICHRA Explained - Everything You Need to Know About Individual Coverage HRA's with Kyle Estep