The Benefits Playbook

This episode features an interview with Sara Richards, Director of Benefits at Red Bull. With experience spanning the consulting, TPA, and in-house side of benefits, Sara’s experience gives her a unique perspective around what’s possible when it comes to developing and administering customized health and welfare solutions. 

In this episode, Kirk and Sara explore strategies for simplifying and effectively communicating benefits, the practical implementation of point solutions, and utilizing AI to improve employee engagement and fraud prevention.

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“ I am optimistic for those who are willing and able to not stop fighting to change the status quo. I'm optimistic as long as you are willing to put in the work to not just keep going with things and to get ahead of trends and to look at the unconventional solutions.  If you dare and you don't give up, then I am optimistic that we will be able to make this better, and that we as the employers have this ability to bring our buying power to truly impact change. With a layer of pessimism of, and if you don't dare, then it's not gonna be a fun ride for you in the next five, six years.” – Sara Richards

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Episode Timestamps:

*(00:51): Sara’s career journey

*(06:28): Innovative communication strategies 

*(13:06): Direct contracting and primary care

*(21:41): Shared savings and fraud prevention

*(32:26): The role of AI in benefits

*(36:41): Optimism for the future

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Links:

Connect with Sara on LinkedIn

Connect with Kirk on LinkedIn

Learn more about Collective Health

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This episode features an interview with Robert E. Andrews, CEO of Health Transformation Alliance (HTA), where he oversees the strategic direction of 60+ corporations that aim to fix our broken healthcare system. Prior to HTA, Robert served as a Member of the United States House of Representatives for nearly 24 years and was an original author of the Affordable Care Act.

In this episode, Kirk and Robert discuss the evolving trends in health care, the potential impacts of gene therapy, and the importance of reducing friction in health benefits administration for employers.

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“ When you have 5 million lives, which we do, and $40 billion worth of spend, we're able to go to behavioral health providers and say, people shouldn't have to wait six weeks to see a psychiatrist when they're feeling anxious or depressed. Why can't they see them in six days or less? And we're able to do that to expand the networks that are available.  So that's how we measure our effort.  Both in terms of the price that you pay and we think more importantly, the service that you get and the quality of the work that you get. So we're really all about using the leverage of collective bargaining to improve outcomes.” – Robert E. Andrews

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Episode Timestamps:

*(00:58): Reflecting on the Affordable Care Act

*(02:17): Current health care system challenges

*(12:50): Founding of Health Transformation Alliance

*(19:08): Employer challenges and solutions 

*(30:43): Future of health care and AI

*(37:53): Global health care perspectives

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Links:

Connect with Rob on LinkedIn

Learn more about HTA

Connect with Kirk on LinkedIn

Learn more about Collective Health

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This episode features an interview with Jen Jones and Cody Fair from Noom Health. Jen is the Director of Clinical Solutions and supports teams with alignment on client needs and clinical programs. Cody serves as the Chief Commercial Officer leading the company’s commercial division and drives growth initiatives across all segments.

In this episode, Kirk, Jen, and Cody explore the importance of integrating GLP-1 medications with behavior change programs, challenges related to yo-yo dieting and coverage, and how Noom Health employs tools like body scans and AI to enhance user engagement and outcomes.

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“ There's just an incredible level of frustration at the employer level right now because they genuinely want to do something obviously, that is helping their employees and their members. They want to be able to provide these medications that they know can be incredibly effective. But at the same time, they have to be good stewards of the business and the cost. And that's again, really where the two come together is being able to provide a patient experience and benefit, but weighing that against the cost. And so trying to find a solution that allows them to go down that middle road where they can control the cost, but still allow an ideal patient experience and have the access to medications that can be effective.” – Jen Jones

“ What AI will allow us to do is to mine these massive data sets and really start to understand human behavior deeper to where we'll know the exact time that I should reach out to this individual with the exact note that I should send them to make sure we kind of keep them on the program, so to speak. For that person that's going to fall off the wagon and we're never going to see him again. It will give us the ability to figure out the times that we should reach out and how we should reach out and that type of messaging. Something that just pure human intervention would not be able to deliver.” – Cody Fair

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Episode Timestamps:

*(01:01): Jen and Cody’s journeys to Noom Health

*(06:02): The importance of behavior change 

*(16:38: The role of GLP-1 medications

*(25:33): Managing GLP-1 costs and access

*(34:59): The future of GLP-1s and Noom Health

*(38:05): Leveraging AI for better health outcomes

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Links:

Connect with Jen on LinkedIn

Connect with Cody on LinkedIn

Connect with Kirk on LinkedIn

Learn more about Collective Health

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The healthcare system feels broken. Costs are skyrocketing, transparency is nonexistent, and too many people are left wondering, ‘Why is this so complicated?’ Welcome to The Benefits Playbook—where we fight the good fight for a better healthcare system.

This season, we are joined by new host Kirk McConnell, Commercial Leader at Collective Health. This year, Kirk sits down with the boldest minds leading the health benefits revolution: industry disruptors, fearless benefits leaders, and healthcare changemakers who are taking real action. We’re pulling back the curtain on hidden costs, exposing the inefficiencies, and revealing the playbook for a system that actually works.

If you're tired of the same old healthcare nonsense and ready to take action, join us for season 3 of The Benefits Playbook, brought to you by Collective Health.

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Links

Connect with Kirk on LinkedIn

Learn more about Collective Health

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This episode features an interview with Ali Diab and Halle Tecco. Ali is the CEO and Co-founder of Collective Health, the world’s leading employer health benefit plan administration platform. Prior to co-founding Collective Health, he held executive and management positions at AdMob by Google, Goldman Sachs, Microsoft, and Yahoo!. Halle is an entrepreneur and Adjunct Professor at Columbia Business School, Course Director at Harvard Medical School, and Collective Health Board Member. Passionate about fixing the U.S. healthcare system, she founded Rock Health, the first venture fund dedicated to digital health, and co-founded companies such as Cofertility and Natalist. Halle is also the co-host of The Heart of Healthcare podcast.

In this episode, Sasha, Ali, and Halle discuss consumer-focused healthcare, the role of AI in enhancing member experience and the care economy, and the potential for public-private partnerships in managing healthcare costs.

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“Are you a consumer-focused or customer-focused healthcare company? Or are you a self-interested healthcare company? I think, sadly, a lot of the incumbent players in our industry are more self-interested than they are customer-focused. I think that's the thing that is the hallmark of Collective Health. That's why we exist because we don't think people are being served in the way that they should with that kind of customer obsession that we see in other industries that leads to great things, including the appropriate use of technology to make that experience better.” – Ali Diab

“I think that because we are the end payers through tax dollars, through lower wages, through direct payment, out-of-pocket spending, we deserve to have the players listen to our needs and our demands to lower the cost. But unfortunately, we have an industry that's profiting quite nicely from us, so it's going to take a lot of work, collective work. But, we have no choice. We can't leave the system to our children and grandchildren like this.” – Halle Tecco

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Episode Timestamps:

*(01:04): Ali’s personal health journey that led to Collective Health  

*(06:28): Halle’s journey in digital health

*(15:42): How digital health is changing the industry

*(25:55): The impact of member experience

*(31:19): The role of AI in healthcare

*(44:27): Future trends in healthcare

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Links:

Connect with Ali on LinkedIn

Connect with Halle on LinkedIn

Listen to The Heart of Healthcare

Connect with Sasha on LinkedIn

Learn more about Collective Health

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This episode features an interview with Michael Menerey, Senior Vice President of Alliant Insurance Services. He currently oversees and manages the Los Angeles employee benefits team and is focused on new business development and recruiting and developing talented team members. Michael has been with Alliant for over 20 years in various roles such as Vice President and Benefits Consultant. In 2021, he was named by Risk & Insurance Magazine as a 2021 Power Broker® Award Recipient for Employee Benefits. 

In this episode, Sasha sits down with Michael to discuss the broken aspects of the traditional healthcare system, the lack of price transparency and quality metrics in healthcare services, and the necessity of tailored communication strategies for different workforce demographics.

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“When you're fully insured, there's just not a lot of levers that can be pulled from a cost containment standpoint. Once you move into that self-funded world, there is just a whole universe of different levers and tools at your disposal that can not only control cost, but can also improve the quality of care for employees and improve the member experience, relative to what it is in a traditional insurance model or even the traditional healthcare system.” – Michael Menerey

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Episode Timestamps:

*(01:19): Michael’s career journey  

*(02:54): Why healthcare is broken 

*(11:49): The benefits of self-funded health plans 

*(20:18): Three point solutions that every employer should consider 

*(24:36): How workforce demographics impact benefit plans and communications

*(35:23): Michael’s advice for how to manage your day

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Links:

Connect with Michael on LinkedIn

Connect with Sasha on LinkedIn

Learn more about Collective Health

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This episode features an interview with Brian Olsen, Partner of Employee Benefits at Sterling Seacrest Pritchard. Brian is an experienced Client Advisor specializing in creative employee benefits strategies to mitigate risks of health plans for companies ranging from 50 to 5,000 employees. His expertise resides in data management solutions and analysis, pharmacy cost containment, and complex contract negotiations. 

In this episode, Sasha and Brian discuss the intricacies of working in the TPA space, the importance of clinical data in managing healthcare costs, and how to advise clients on network selection, PBMs, and stop-loss insurance strategies.

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“The TPA is the quarterback for a client's self-funded plan. Pulling together all the different players: the PBM, the stop-loss, the broker, the client. Making sure everybody is working as one to execute the plan for the self-funded health benefits. The biggest benefit is a client's flexibility as they're coming to design that game plan. What kind of network do we want to use? How do we want to pay certain types of claims?” – Brian Olsen

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Episode Timestamps:

*(01:40): Brian’s career journey  

*(05:49): Understanding the TPA model

*(12:42): Pharmacy benefit management insights

*(18:02): Non-ERISA business and transition challenges 

*(26:27): Importance of clinical data insights

*(30:07): Brian’s advice for those new to the industry

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Links:

Connect with Brian on LinkedIn

Email Brian

Connect with Sasha on LinkedIn

Learn more about Collective Health

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This episode features an interview with Kristen Jordan, Benefits and Wellness Manager at Chime. She is responsible for the development, implementation, and maintenance of various programs that enhance employee well-being and satisfaction. Kristen has a proven track record for designing and managing benefit plans, wellness initiatives, and vendor relationships that align with the company's vision and values.

In this episode, Sasha sits down with Kristen to discuss the importance of benefits education, customized wellness programs, and the impact of a leave of absence management tool.

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“When we think about wellness programs, you really do have to tailor them to your specific company. You can't just put a one-size-fits-all program in there because you may not see the results or the engagement that you're looking for when it comes to implementing a wellness program.” – Kristen Jordan

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Episode Timestamps:

*(01:21): Kristen’s career journey  

*(04:29): Wellness and benefits at Chime 

*(14:16): How Chime supports employees 

*(18:21): How Chime builds each year’s benefits plan 

*(24:09): Ensuring a great member experience

*(33:00): Kristen’s advice for those new to the industry

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Links:

Connect with Kristen on LinkedIn

Learn more about Chime

Connect with Sasha on LinkedIn

Learn more about Collective Health

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This episode features an interview with Doug Ramsthel and Jaclyn Rielly of Burnham Benefits. Doug serves as the Executive Vice President and Partner of Employee Benefits, and Jaclyn is the Vice President of the Irvine Office. 

In this episode, Sasha, Doug, and Jaclyn discuss how the shift in pharmacy is affecting employers and members, the rising trend of GLP-1s, and why covering gene therapy drugs is important.

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“If I can convert somebody from a drug where I'm getting a $382 rebate to a cheaper drug where my net cost is a lot lower, that's a better benefit strategy. The only way to do that, in my opinion, is to take control as an employer. Self-fund and be able to start hitting these control buttons that will customize the plan, so you're focusing on the right things. Whereas the PBMs could be focusing just on their rebates because they're getting a slice of it. That's how they make their money.” – Doug Ramsthel

“Employers are really starting to get creative when it comes to managing their drug spend, and they have to, while focusing on different financial factors, as well as member behavior, when it comes to controlling costs. As plan costs for prescription drugs increase, member costs typically follow suit, whether it be through increases in cost sharing or premium contributions. With over 70% of office visits and hospital visits involving drug therapy, the rising costs of pharmacy are becoming more and more visible at the member level. I think the biggest shift, though, in pharmacy affecting members today really is that of access and affordability.” – Jaclyn Rielly

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Episode Timestamps:

*(01:13): How the shift in pharmacy is affecting employers and members

*(16:18): Doug discusses his book and obesity treatments 

*(19:46): Doug dives into GLP-1s 

*(33:08): Jaclyn discusses gene therapy drugs 

*(45:50): Jaclyn explains the value-based formulary idea  

*(49:40): Final thoughts on gene therapy drugs and GLP-1s

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Links:

Connect with Doug on LinkedIn

Connect with Jaclyn on LinkedIn

Connect with Sasha on LinkedIn

Learn more about Collective Health

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This episode features an interview with Dr. Smita Das, Vice President of Psychiatry and Complex Care at Lyra Health. Smita is board certified in psychiatry, addiction psychiatry, and addiction medicine and has over 20 years of research experience. Previously, she served as President of an American Psychiatric Association District Branch and chair of the APA's Council on Addiction Psychiatry. Smita is also a clinical associate professor of Psychiatry and Behavioral Sciences at Stanford School of Medicine.

In this episode, Sasha and Smita dive into Lyra Health’s Complex Care Program, how the conversation around sobriety is changing, and how addiction and mental health psychiatry differ and intertwine.

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“There's so many places where somebody can fall through the cracks, for one reason or another. It could be coverage. It could be that they couldn't find a facility or that there were too many options and they had analysis paralysis, or they went to a place that wasn't actually evidence-based or at the bar that we expect at Lyra. Then, they're actually worse off because now maybe they've paid out of pocket tens of thousands of dollars and they didn't actually get better.” – Dr. Smita Das

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Episode Timestamps:

*(01:28): Smita’s career background 

*(05:25): Why point solution access is important 

*(09:15): Smita explains Lyra Complex Care

*(23:50): How addiction and mental health psychiatry differ and intertwine

*(29:15): Examples of employers who have accessible recovery programs

*(33:12): Smita’s advice for employers looking into complex care

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Links:

Connect with Dr. Das on LinkedIn

Learn more about Lyra Health

Visit Rethinking Drinking

Visit SAMHSA

Visit Atlas

Visit Findhelp

Visit NAMI

Connect with Sasha on LinkedIn

Learn more about Collective Health

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