"Nomi actually stands for 'no middleman'. Take out that invented complexity... Price comes way down, becomes more simple to administer, and there's plenty of dollars to go around for providers now making more money." - Josh Walker

My guest this week, Josh Walker, Founder & COO of Nomi Health, is on a mission to rebuild healthcare by tackling its "invented complexity." He joined me on the show to explain why creating a direct relationship between the buyers and providers of care is the key to a better, more affordable system for everyone.

How does Nomi do it? We break down their playbook, which focuses on three core strategies: standardizing data formats to improve efficiency, embracing price discovery to find the true cost of care, and simplifying payment dynamics to cut out the middlemen.

This isn't just theory. Joshua shares the powerful, real-world results of their model, including how one client's benefits leader received a standing ovation from employees after switching to a plan that eliminated all financial barriers to care.

Tune in this week to learn why it’s so important to find the true cost of care, and why I’m so proud to have Nomi as a sponsor for the show!

Chapters:

(00:00:44) What Does NOMI Stand For? 

(00:11:36) Finding the "True Cost of Care" 

(00:23:27) Do We Even Need Networks Anymore? 

(00:35:14) What Churros Can Teach Us About Data Analytics 

(00:52:19) From Solution Taker to Solution Maker 

(00:55:59) The "Standing Ovation" Health Plan

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/

“Does your consultant understand these kind of strategies and mechanisms are available in the market and do they know how to implement them and make them work?" - Riley DearingRiley Dearing of Hotchkiss Insurance returns to the show this week, and he’s brought with him Blake Allison, CEO of Employers Health Network (EHN) to talk all about high-performance health networks and the massive opportunity they represent.Ever wonder how high-performance health networks actually work? We broke down the real mechanics: how direct provider partnerships are built, how benefit design drives engagement to the right facilities, and how this collaborative approach leads to better data, lower costs, and predictable risk for employers.This isn't just theory; we also announce EHN's new partnership with Covenant Health, detailing how this model is being scaled to bring these powerful solutions to employers across West Texas.Tune in this week for the definitive guide on how high-performance health networks actually work!Chapters:(00:00:00) How the World's #1 Chevy Dealer Saved $3 Million on Healthcare

(00:10:30) Enhancing Healthcare Networks

(00:16:23) Making Sure Members Can Get Care In Their Area

(00:22:30) Empowering Patients

(00:25:43) Navigating Healthcare Pricing Strategy

(00:35:23) Enhancing Healthcare Affordability

(00:47:14) Data-Driven Healthcare

(00:57:17) Zero Out-of-Pocket Cost For MembersKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.This episode covers healthcare news from June to mid-July 2025.And we play a new game called the "Which Has Less Ingredients?", which is exactly like what the title suggests.Chapters: 0:00 - Intro0:22 - A proposal to ban drug ads2:48 - Pre-diabetes rates in children have tripled in 25 years5:25 - Healthcare workers leaking patient data through AI7:06 - Mark Cuban's healthcare plan10:05 - Healthcare is the top employer in most states12:49 - The Self-Funded Review19:37 - Which Has Less Ingredients? (this month's game)27:27- Ask Spencer AnythingSources: https://phys.org/news/2025-06-glass-bottles-microplastics-plastic.htmlhttps://x.com/mcuban/status/1934834421225672999https://www.scrippsnews.com/health/alarming-number-of-adolescents-have-prediabetes-new-data-from-cdc-says?utm_source=chatgpt.comhttps://x.com/utobian/status/1943127594960064713?t=BfpiRV8m7thZDIqTRMVo3Ahttps://www.medicaleconomics.com/view/health-care-workers-are-leaking-patient-data-through-ai-tools-cloud-appshttps://www.medicaleconomics.com/view/sanders-senators-float-ban-on-direct-to-consumer-ads-for-prescription-drugshttps://newsnetwork.mayoclinic.org/discussion/mayo-clinics-ai-tool-identifies-9-dementia-types-including-alzheimers-with-one-scan/

“That race car you got, that you studied all the components and now you're just tweaking horsepower and how much can you get out of it? That's what this feels like. You are really optimizing the horsepower of this engine, your employee benefit plan, and everybody likes it.” - Bently Durant

This week, I was joined by an all-star duo: Bently Durant, the COO of Classic Chevrolet, which is the #1 Chevy dealer in the world, and his benefits advisor, Riley Dearing of Hotchkiss Insurance.

Together, we discussed the story of how they saved $3 million while simultaneously improving care by eliminating deductibles and optimizing pharmacy spend, which is a playbook that every business owner, CFO, and consultant can learn from. Bently, Riley, and I talked about what makes this industry so unique and why self-funding is so beneficial for car dealerships.

We also dove into the truly innovative things they're doing now that their plan is so successful, like creating a "Good Decision Fund" to give bonus money back to their employees.

Tune in this week to learn how to optimize the horsepower of an employee benefits plan!

Chapters:

(00:00:00) How the World's #1 Chevy Dealer Saved $3 Million on Healthcare
(00:04:10) When Bently Decided To Go Self-Funded
(00:14:08) Tailoring Health Plans To Your Employees
(00:31:19) The Complicated World Of Pharmacy Spend
(00:58:27) Improving The Benefits Plan WHILE Saving Money

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/

"If employers do not think that they are in the healthcare business, they are sadly mistaken. Every employer is in the healthcare business whether they want to or not." - Stephanie Koch

I’m super excited about this week’s episode: the Empowering Employers live panel show that we recorded in front of a live audience on June 18th. I was joined on-stage by an all-star group of guests: Rachel Strauss, Kimberly Carleson, Kristen Rivers, and Stephanie Koch. 

Together, we discussed some of the biggest challenges and opportunities for employers in today’s market; the diversity of perspectives on-stage made this a super insightful podcast, and whether you’re an employer, consultant, or solution provider, there’s a lot you’ll take away.

We also had live Q&A after the main podcast, with some hard-hitting questions from Omar Arif, Elaine Davis, and more.

Tune in this week to learn how we can better empower employers!

Chapters:

(00:00:00) The Empowering Employers Live Show, with Q&A
(00:13:00) How Do We Get More Transparent Healthcare Pricing?
(00:21:25) What Is The PBM’s Role In Better Healthcare Strategies?
(00:29:00) Lowering Healthcare Costs Through Claim Review
(00:40:11) PBM Reform Through Strategic Legal Actions
(00:48:45) How Do We Pay For GLP-1s?
(01:01:22) Live Audience Q&A
(01:38:10) Final Thoughts From Each Panelist

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/

 "There is no such thing as a health or medical problem for which we are not your partner." - David Silverstein

The U.S. healthcare system is the third-largest economy on the planet, which makes expecting patients to navigate all of its complexities pretty unrealistic. This week’s guest, David Silverstein, is aiming to make healthcare simpler for the end user, steering them when appropriate to the best care and becoming their first point of contact with the healthcare system. 

David explains why the system is designed to create friction, from unnecessary tests to proprietary pricing that hides the true cost of care. He also told me about his experience trying to get legislation passed that would make healthcare costs more transparent, and the lobbying groups he ran up against in that attempt. 

Tune in this week to learn how we make healthcare simpler for Americans!

Chapters:

(00:00:00) How Do We Make Healthcare Simpler? | with David Silverstein
(00:06:30) Streamlining Healthcare With Modern Tech
(00:12:37) Pushing For More Transparent Healthcare Legislation
(00:22:30) Fair Pricing for Informed Healthcare Decisions
(00:33:37) Virtual Healthcare Navigation and Coordination
(00:59:37) More Transparent Healthcare Costs

(01:15:22) Patient-Centered Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/

“As a broker, our job is counting cards against the system. Because everything catches up 5-10 years later. Every other broker, every other consultant gets in like, oh, that's a great idea. We're always trying to find the next little thing, and then the system eventually shuts it down because it messes with somebody's money." - Taylor Orton

What does it mean to be on the bleeding edge of employee benefits? My next guest, Taylor Orton, CEBS, of Cottingham & Butler, frames the work of a top consultant as “counting cards against the system”, and trying to continuously stay ahead of the market. 

Taylor broke down several of the key areas of cost containment that are often employed by brokers and gave his take, as well as what it means to be on the “bleeding edge” of benefits. He also shared with me why cost containment doesn’t just mean lowering the “unit cost” of healthcare; it also means trying to reduce the number of “units”. 

Much of this conversation was on the big picture of the healthcare landscape, so if you’re a self-funded geek, this one is for you.

Chapters:

(00:00:00) Why Brokers Need To Be Constantly Innovating | with Taylor Orton
(00:10:44) Optimizing Healthcare Benefits Plans
(00:16:14) Why Procurement Strategies Are So Key To Cost Management
(00:33:22) Market Forces' Impact on Healthcare Pricing
(00:46:54) Employer Transparency About Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/

“There's this ability to impact people directly through the employer in a very cost effective way, giving everyone the chance to improve their health. The more employers that we can impact, the more people we're going to impact." - Erica Armstrong

I recently had the pleasure of speaking with Erica Armstrong, MD, IFMCP, the founder of Root Functional Medicine, who is on a mission to use functional medicine to find and treat the root cause of our health issues. After first connecting with Erica on LinkedIn, I was excited to have her on the show to discuss her holistic approach to healthcare.

We discussed the core pillars of functional medicine, including a nutrition-first care model, the critical importance of a healthy gut microbiome, the keys to inflammation management, and even the potential for reversing chronic conditions. We also cover how she is bringing this new, more comprehensive model to employers and their employees.

Tune in this week to learn all about functional medicine!

Chapters:

(00:00:00) Functional Medicine 101 | with Erica Armstrong
(00:05:37) The “Root Cause” Approach
(00:07:03) Holistic Approach Of Functional Medicine
(00:16:56) Nutrition-First Care
(00:25:59) The Importance Of A Healthy Gut Microbiome
(00:34:46) Chronic Condition Reversal
(00:44:10) The Key To Inflammation Management

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/

If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.

Each month on Last Month In Healthcare, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions. This month, we were joined in studio by Shawn Ferguson from Acrisure!

This episode covers healthcare news from May 2025, including:

- Trump's 'most favored nation' executive order

- AI in the FDA

- FDA's plan to review chemicals in our food supply

- Prices for new drugs doubling in the last 4 years

- Hospitals outsourcing minor surgeries

- The DOJ lawsuit against Aetna, Elevance, and Humana

And we play a new game called the Macro Matchup, where Spencer and Shawn attempt to guess the calories, sugar, fat, and protein of 4 very unhealthy fast food items.

Chapters:

0:00 - Intro

1:01 - Healthcare Headlines

18:21 - The Self-Funded Review

31:29 - Macro Match-up (this month's game)

38:06 - Ask Spencer Anything

Sources:

• https://www.healthcaredive.com/news/trump-most-favored-nations-drug-pricing-plan/747761/
• https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-centers-deploy-ai-internally-immediately-2025-05-08/
• https://www.reuters.com/world/us/fda-plans-review-chemicals-us-food-supply-official-says-2025-05-15/
• https://www.reuters.com/business/healthcare-pharmaceuticals/prices-new-us-drugs-doubled-4-years-focus-rare-disease-grows-2025-05-22/
• https://www.healthleadersmedia.com/innovation/healthcare-diversified-hospitals-are-outsourcing-minor-surgeries
• https://www.reuters.com/sustainability/us-files-false-claims-complaint-against-three-health-insurers-2025-05-01/

"I want to be in our own category." - Rob Gelb

I recently joined Rob Gelb, CEO of Vālenz, which is a sponsor of this show, at the Vālenz office in Philadelphia to discuss the story of the company, how it operates in the market currently, and it’s future, which includes the recently announced Vālenz One. 

Rob describes VālenzONE as a “health plan optimizer”, and we discussed what that means and what it looks like to build a new way for employers to manage their healthcare. We also discussed the healthcare market as a whole, what it’s currently lacking, and Rob’s general philosophy of how he’s approached building this new platform.

Tune in this week to learn all about VālenzONE!

Chapters:

(00:00:00) What Is VālenzONE? | with Rob Gelb
(00:08:03) How Data Can Reduce Health Plan Spend
(00:19:48) How Vālenz Has Transformed Over The Years
(00:22:43) What Does Optimized Healthcare Look Like?
(00:36:58) Why Integrated Health Solutions Are The Future
(00:41:34) Innovative Healthcare Collaborations
(00:50:17) What Does It Mean To Be Innovative?

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch 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/