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:

Executive Medical Benefits with ArmadaCare - Rachel Rutherford

This week's episode features Rachel Rutherford, Sales Director at ArmadCare, where she and host of @SelfFunded with Spencer - Spencer Smith, dive into the world of Executive Benefits.

In today's competitive job market, attracting and retaining top talent is crucial for the success of any organization. Human Resources (HR) directors play a vital role in determining organizational benefits and tailoring them to individual needs. This episode explores the importance of HR in tailoring benefits and attracting top talent.

One key concept highlighted in the episode is the "Zone of Genius." This refers to the intersection of an individual's natural skills and true passions, which leads to career fulfillment and success. By tailoring benefits to cater to the unique needs and aspirations of employees, HR can create an environment where individuals can thrive in their respective zones of genius.

Enhanced benefits, such as ArmadaCare, a supplemental medical reimbursement plan, are discussed as a way to attract and retain top talent. ArmadaCare offers tax advantages, full insurance coverage, and compliance with the Affordable Care Act. While these enhanced benefits may raise questions of fairness to some, they are seen as a valuable tool for caring for key employees and ensuring their well-being.

Rachel Rutherford emphasizes the importance of considering the impact on both the employer and the employees when making decisions about tailoring benefits. She highlights the significant cost of losing key talent and the subsequent expenses associated with replacing them. Retention tools, such as enhanced benefit packages, can save companies hundreds of thousands of dollars in lost productivity and knowledge.

One interesting approach mentioned in the episode is the idea of incentivizing longevity with the employer. By offering different levels of benefits based on years of service, HR can encourage employees to stay with the company. This approach aligns with the goal of attracting and retaining top talent while also considering the financial implications for the organization.

However, there are tradeoffs involved in balancing different factors when tailoring benefits. Rachel acknowledges that increasing benefit packages for recruitment and retention purposes can become expensive, especially when offering them to all employees. HR professionals need to understand the underlying needs and motivations of employers when they request richer plans or retention strategies. It is essential to learn the question behind the question and provide tailored solutions that meet the specific needs of the organization.

In conclusion, the role of HR in tailoring benefits and attracting top talent is crucial for the success of organizations. By understanding the unique needs and aspirations of employees, HR professionals can create benefit packages that align with individual goals and foster career fulfillment. However, there are tradeoffs and challenges involved in balancing different factors, such as cost and fairness. HR professionals must consider the impact on both the employer and the employees when making decisions about benefits. Ultimately, by tailoring benefits and considering the evolving landscape of healthcare, organizations can attract and retain top talent, driving their success in the long run.

Tune into the full episode now!

Chapters:

00:02:46 Tailoring Benefits to Individual Employee Needs

Today, we're diving into the world of affordable and accessible healthcare benefits for hourly employees. Meet Hooray Health, a game-changer in the industry that aims to bridge the gap between basic healthcare needs and major medical insurance. With their innovative approach and data-driven insights, Hooray Health is revolutionizing the way we think about healthcare. So, let's jump right in and explore their journey!

The Birth of a Vision:

Shane Foss, the CEO and founder of Hooray Health. They recognized the lack of transparency and affordability in urgent care services and saw an opportunity to make a difference. Inspired by the success of their urgent care model and its similarities to direct primary care, they decided to create a bundled or flat rate system for urgent care visits.

Overcoming Challenges and Building a Network:

To make his vision a reality, Shane gathered urgent care doctors for a roundtable discussion. By identifying common issues and pain points, they developed a contract that was met with enthusiasm by the doctors. This contract offered a $25 copay with no balance bill, eliminating the dreaded surprise medical bills that plague so many.

Building a network of providers in major metro areas was no easy task, but Hooray Health persevered. Within six months, they established contracts with over 50% of urgent cares in the United States, covering 85% of the population within 10 miles of a contracted provider. Talk about accessibility!

Scaling Up and Success:

After their initial success, Hooray Health expanded nationally within two years. Today, they boast a high retention rate and have not lost a client in four years. Siemens Energy, a client for five years, is a testament to the trust and satisfaction their services provide.

Understanding the Limitations:

It's important to note that Hooray Health is not major medical insurance. Instead, it serves as a valuable alternative for those who don't have insurance or need additional coverage. While they cover basic healthcare needs, they do have limitations for catastrophic events. However, they can sit underneath a subsidy on the exchange for individuals who weren't offered an employer-sponsored health plan.

Innovation and Collaboration for a Better Future:

Hooray Health's success story goes beyond providing affordable and accessible healthcare benefits. Spencer and Shane emphasize the need for improved access, transparency, and collaboration between the government and the industry. They believe that by working together, we can address the current issues plaguing the healthcare system and pave the way for a brighter future.

Conclusion:

Hooray Health's journey is a testament to the power of innovation and collaboration in the healthcare industry. By focusing on affordability, accessibility, and meaningful benefits, they are filling the gap for hourly employees who deserve quality healthcare without breaking the bank. With their mobile app, provider network, and commitment to doing the right thing for their members, Hooray Health is paving the way for a future where healthcare is truly accessible to all.

So, let's raise a cheer for Hooray Health and their mission to revolutionize healthcare! Together, we can build a system that prioritizes the well-being of every individual, regardless of their employment status or income level.

Here's to a healthier and happier future for all!

Chapters:

00:00:00 Hooray Health: Affordable and Accessible Healthcare

00:05:39 Opportunity in Urgent Care

00:11:55 Scaling a Direct Primary Care Model

00:18:07 Success in Implementation and Client Management

00:24:53 High Deductible Pregnancy Coverage

00:31:04 Affordable Alternative to Major Medical Insurance

00:37:22 Expanding Access to Affordable Healthcare

00:44:00 The Future of Healthcare

Welcome to Episode 112 of Self-Funded with SPencer, featuring Landon Fielding of Brite!

From Tragedy to Triumph: The Journey of Writing 'Wounds'

In this week's episode of the podcast "Self Funded" with Spencer, hosted by Spencer Smith, performance coach Ryan Miller shares his unique coaching approach that combines psychology, self-perception, and personal branding.

(00:32:49) Embracing Authenticity for Personal Branding Success