This episode features an interview with John Meister, Principal and Senior Vice President of Employee Benefits at Newfront. John provides top-tier consulting, creative strategies, and employee advocacy on behalf of his clients nationwide. Prior to Newfront, John spent five years leading Client Strategy and Execution at Woodruff Sawyer and held Employee Benefits roles at One Digital and Burnham Benefits.

In this episode, Sasha sits down with John to discuss transitioning to self-funded solutions, key components of a great member experience, and building point solutions into benefits programs.

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“When I talk with some companies that are unfamiliar with self-funding, really, they think it's just this totally apples and oranges approach. I try to just explain to them, ‘Hey, built into your premiums right now, we can take a look at what the insurance companies are doing for self-funding. They have stop loss built-in. They have their PBMs built-in. And there’s just layers of admin costs and profit built into each of these that then comprises your premium rate that you're getting charged.’ Just by trying to compare it to what they know right now, to then what it would be to self-funding, that also, I think, is usually a big light-bulb moment for a lot of clients. Just to feel like, ‘Oh, this isn't actually that much different than what I'm doing.’ It's just, ‘Hey, we're going to set the rates for what we say you should budget for. It's going to be that set number that you're used to.’ Conversations like that usually are the foundation to then go on.” – John Meister

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Episode Timestamps:

*(01:13): John explains Newfront 

*(08:19): How John talks to his clients about moving to self-funded solutions

*(24:14): The key components of a great member experience for clients

*(28:49): John discusses point solutions and the difference it makes in benefits programs 

*(31:51): John’s advice to those new to the industry

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Links:

Connect with John on LinkedIn

Connect with Sasha on LinkedIn

Learn more about Collective Health

This episode features an interview with Dr. Bapu Jena, an economist, physician, and professor at Harvard Medical School. He bridges his professions to explore the economics of healthcare productivity and medical innovation. Bapu is also a faculty research fellow at the National Bureau of Economic Research and practices medicine at Massachusetts General Hospital.

In this episode, Sasha and Bapu discuss his book Random Acts of Medicine, provider-level quality scoring, and designing employer-sponsored benefits.

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“If you're an employer and you're thinking about how to structure your benefits for your employees, you're going to think about which hospital systems you want them to have access to. You're going to think about what doctors’ groups or doctors’ practices you want them to have access to. Naturally, you're going to want to have information on what is the quality of those places. But then how do you measure quality? What we might say about a particular doctor in terms of their quality, might be a function of their actual skill and the true quality that they provide. It could also be a function of the resources that their practice has, or the types of patients that they see. If you want to know something about what is the true effect of seeing that particular doctor, you've got to sidestep all these thorny empirical problems.” – Dr. Bapu Jena

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Episode Timestamps:

*(01:09): How the fields of healthcare and economics correlate with each other 

*(04:02): Bapu dives into his book Random Acts of Medicine

*(10:09): What provider-level quality scoring is and how it works 

*(18:00): Bapu’s thoughts on employer-sponsored benefits 

*(25:21): Good spend versus bad spend when building benefits plan designs

*(27:29): Challenges providers and payers will face as healthcare evolves  

*(36:33): Bapu shares his favorite healthcare story

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Links:

Read Bapu’s book Random Acts of Medicine

Random Acts of Medicine Substack

Listen to Freakonomics MD Podcast

Connect with Sasha on LinkedIn

Learn more about Collective Health

This episode features an interview with David Duenas, Life Science Practice Leader at HUB International. HUB International is a leading full-service global insurance broker providing property and casualty, life and health, employee benefits, investment and risk management products and services. David has served the company for nearly 20 years in Consulting and the Life Sciences Practice space.

In this episode, Sasha and David discuss how to move to a self-funded solution, crafting a better member experience, and the value of human connection.

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“I think the biggest challenge that we face is the complexity of the healthcare system. And that's everyone in that, in the delivery of that benefit. Whether it's at the carrier level, the consulting level, the providers, the hospitals, and getting all of that to integrate and speak to one another for the benefit of the employee. That, I think, is really the biggest challenge. Our industry is probably one of the few that takes all of its complexity, all of those connection points – and they are many – and we just drop this on the lap of the employee or the participant, if you will, and we just hit them on the rear end and say, ‘Good luck.’ And the fluency of most employees is they don't interact with the health plan with any commonality. They're just not there on a daily basis, so it's foreign to them. And so, we could try and increase their fluency but also the delivery, so it makes it easier for them.”– David Duenas

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Episode Timestamps:

*(00:54): David’s answer to “Why do you do what you do?” 

*(02:06): Challenges members are facing in the healthcare industry 

*(04:06): Components of a best-in-class program

*(06:17): The directive David sees from the carrier industry

*(09:46): How David talks to clients about moving to a self-funded solution 

*(16:31): How the hospital experience trickles down to employers 

*(23:45): David shares a story from the early days of his career

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Links:

Email David

Connect with David on LinkedIn

Connect with Sasha on LinkedIn

Learn more about Collective Health

This episode features an interview with Lee Lewis, Chief Strategy Officer and General Manager of Medical Solutions for Health Transformation Alliance (HTA). At HTA, he spearheads efforts across 50 large employers and six million employees to transform healthcare, save lives, and save millions of dollars. Lee has spent his career advising Fortune 10 employers, insurance companies, medical associations, and the Departments of Justice and Labor. 

In this episode, Sasha sits down with Lee to discuss the benefits of a TPA versus an ASO, virtual primary care, and putting trust back into healthcare.

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“If you are a huge employer, if you’re AT&T or Walmart, you have enough leverage that carriers will build systems in place that enable you to do creative things. The difference between a TPA and a carrier is, it's still remarkable but it's smaller. The gap is smaller. But, if you're a small employer, you don't have the buying power with any carrier anywhere. You're a rounding error to them. You're not going to get any type of flexibility or creativity supported. Whereas, if you work with an independent TPA, you can still access a lot of those things that might otherwise only be accessible for a huge employer. Secondly, getting data is really hard with large carriers. If you have a TPA, you have the chance to get your data like a large employer might, even though you're smaller.” – Lee Lewis

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Episode Timestamps:

*(01:09): Lee breaks down TPA versus major carrier options

*(04:53): Busting the myth that TPA is more complicated than ASO

*(10:39): The top 3 components of a best-in-class healthcare benefits program

*(22:05): Lee’s opinion on virtual primary care

*(28:27): Lee discusses self-funded versus fully insured

*(33:17): Lee shares his favorite healthcare story

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Links:

Connect with Lee on LinkedIn

Listen to Broken Benefits Podcast

Connect with Sasha on LinkedIn

Learn more about Collective Health

Employee healthcare represents the second-largest investment for most U.S. businesses. As we all know, navigating the complexities of the system is no easy task. High costs, confusing experiences, and administrative burdens can make it challenging to make the most of healthcare investments.

On “The Benefits Playbook: Strategies for Self-Funded Health Plans”, we’ll provide the insights needed to take control of employee healthcare all while delivering ‌a great member experience.

Listen in to hear from experts in the field and learn how companies can overcome obstacles to find value in their healthcare plans. Plus, we’ll discuss how innovative businesses are changing the status quo and making it easier for their employees to understand and access healthcare.

Join Sasha Yamaguchi, Commercial Leader at Collective Health, and our guests and let us help you in creating a successful strategy for better employee healthcare. Tune in to “The Benefits Playbook”, where we’ll share the latest updates and strategies to maximize your healthcare investments.