Have you ever wondered about the hidden layers of healthcare costs? Today, we bring you insights from an eye-opening conversation with Dr. Keith Smith, co-founder of the Surgery Center of Oklahoma. Dr. Smith shares his personal journey of navigating the healthcare industry, and the shocking discovery that hospitals were not always the best advocates for patients or surgeons. He and his colleague dared to change this by establishing their own facility, a radical move that influenced the Trump Executive Order Mandating Price Transparency.

We're also discussing the rising trend of self-funded healthcare plans and why employers are looking for alternatives to traditional ones. Imagine a zero-deductible and zero-copay approach to healthcare; it's happening, and it's giving companies a competitive advantage in the labor market. But it's not all smooth sailing; there are important regulations to consider like CAA notifications and ERISA. Plus, we highlight why quality assurance remains crucial when choosing healthcare facilities.

Rounding off, we question traditional quality metrics and argue for the value of price transparency in measuring the quality of care. We draw on insights from Marty McCary's book Unaccountable to challenge the reliability of existing quality metrics. Finally, Dr. Smith shares his thoughts on the future of healthcare and the ongoing need for more transparency and patient advocacy. So, sit back and join us for a compelling discussion filled with revelations about the evolving healthcare industry.

Ever wondered how the Pharmacy Benefit Management (PBM) industry really works? Join us for an enlightening chat with our guest, Dave Parker, the Vice President of Sales and Marketing at TrueScript, as we unravel the intricacies of the traditional PBM relationship. Gain insight as Dave dissects key terms like average wholesale price and net cost, and unveils the ways PBMs make their money. We also delve into the trend of manufacturers moving closer to employers to shake off spread pricing models. More importantly, discover why it’s crucial to ask the right questions in a PBM relationship.

We also step into the fascinating world of pharmacogenomics testing for prescription drugs, a game-changing approach that could redefine the healthcare industry. Picture this - a one-time test that prevents the misprescribing of medications, saving patients and doctors from hefty medical bills and hospital stays. Indeed, such a test already exists, and some PBMs are benefiting from the potential savings it brings. We’ll also investigate the prospect of making this a routine test for newborns and what it could mean for stop loss carriers. Last but not least, Dave returns to introduce us to the emergence of transparent PBMs - a revolutionary shift that is transforming the industry and proving particularly appealing to younger consumers. Tune in for an episode packed with industry insights and thought-provoking discussions.

Prepare yourself to be fascinated by Dr. Kyle Rickner, co-founder and chairman at Primary Health Partners, as he takes us on an inspiring journey of how direct primary care became his answer to physician burnout and subpar patient experiences. Step into the world of evolving healthcare models as we dissect the barriers that prevent more physicians from transitioning to this progressive model. Together, we untangle the web of the traditional fee-for-service system and how it has stagnated the growth of direct primary care. We also unpack the implications of misused health insurance and sky-rocketing premiums leading to a precarious cycle of healthcare costs.

In the latter half of our enlightening conversation, we journey across state lines to understand how direct primary care physicians unite in their mission to deliver patient care. Listen to Dr. Rickner narrate the challenges and triumphs of coordinating care for a substantial client base, all while pushing the scalability model forward. We also shine a spotlight on the significance of data collection in establishing the value of direct primary care and highlight the urgent need for educating people about its benefits. Join us and share our curiosity, as we discover how direct primary care is revolutionizing the healthcare industry.

Ever wondered if your business is really understanding the true cost of healthcare? Join us as we pick the brain of Kelly McDevitt, the President of the Nonprofit Integrated Benefits Institute (IBI). With a whopping 40 years of industry experience, Kelly unpacks how IBI assists businesses in deciphering the often-complex healthcare costs beyond just medical and pharmacy expenses. We dive into the increasing curiosity around self-insured plans and the pivotal role of data in employer decision-making. Plus, you'll discover how IBI’s benchmarking data provides a panoramic view, setting the stage for strategic planning.

Then, as the conversation deepens, we navigate the murky waters of delayed healthcare and the difficulties it presents in sourcing relevant claims data. Our journey takes us into the heart of the pandemic's impacts on health and disability claims - including prolonged health issues related to COVID-19. Kelly sheds light on how businesses can utilize this data to craft well-informed decisions, the significance of benchmarking, and the unique challenges HR teams are currently facing. Tune in for an insightful conversation packed with valuable insights for employers seeking to understand the labyrinth of healthcare costs.

Have you ever wondered about the balance between empowering employees and maintaining control as a leader? Get your answers as we have an enlightening conversation with Kristen Hadeed, author of Permission to Screw Up and Leadership Thought Leader. Kristen takes us on her leadership journey, a journey that began when she was 21 and saw 45 of her employees walk out on her, a pivotal event that reshaped her leadership approach. She shares how this experience transformed her into an advocate for fostering an environment of trust, empowerment, and psychological safety.

What if your team could solve problems without micromanagement? Would it be more effective? Kristen takes a deep dive into these questions and unravels the delicate balance between supporting employees and giving them ownership of their work. She also shares her insights on how to avoid micromanagement and the impact it can have on your team’s morale and your own wellbeing. At the heart of her message is the importance of cultivating a culture of trust that encourages constructive feedback.

Can vulnerability be a game-changer in the workplace? Let's find out from Kristen's personal experience. She unveils how her honesty and vulnerability with her team not only led them to trust her but also gave her a second chance. Listen in as she passionately talks about the value of fostering an environment of vulnerability in the workplace. You'll learn the importance of striking a balance between guiding and supporting employees and giving them ownership of their work. It's time to explore the creation of human workplaces where vulnerability is embraced. This episode is loaded with wisdom, practical advice and a fresh perspective on leadership. Don't miss out!

GET KRISTEN'S BOOK: Permission To Screw Up

You ever wonder why the current healthcare system is so expensive and seemingly broken? Get ready to explore the potential of innovative healthcare plan designs that seek to reduce out-of-pocket costs and increase access to care with our special guest, Kevin Kickhaefar, President and Chief Growth Officer at Gravy.  We'll learn about Kevin's fascinating journey from the Midwest to leading a healthcare startup and his vision of a redesigned healthcare system that works for everyone. We'll investigate the integration of direct primary care with plan design, and the challenges that brokers and advisors face in the current climate.

Thinking about level-funded and self-funded plans? Our insightful discussion with Kevin also covers their impact on employers and traditional health insurance carriers. We'll explore how these plans provide employers with more control over their healthcare costs, leading to a more sustainable model for the future. Learn about how direct primary care can bridge the healthcare gap in underserved communities, and how innovative partnerships like the Gravy Pay card and Teladot are simplifying the payment process and virtual visits for patients and providers alike. If you're curious about the future of health insurance, this is one episode you won't want to miss.

Join us for a riveting conversation with our guest, Daniel Grun, Chief Marketing Officer at Leading Edge Administrators.  From nonprofit to insurance, he brings a unique perspective to our discussion about the key factors keeping the market static - cost, access, and education of care.  Daniel drops knowledge on the benefits of strong partnerships and the increasing influence of self-funded plans in the industry. We also dig into the vital role of training and establishing a bond of trust in selling and keeping insurance businesses afloat.

Stay tuned as we navigate the terrains of data lakes, benchmarking, and reference-based pricing, technologies that are radically altering outcomes. Get an inside look at how Artificial Intelligence, guided by correctly labeled data, is bridging the underwriting gap.  Join us as we tackle the responsibilities attached to selling insurance plans, the necessity for proper education, and the thrill (and risk) of being on the cutting edge.  Buckle up for an enlightening discussion on the ever-changing insurance panorama and how to master the art of navigating it.

Are you ready to tackle the trust problem impacting organizations across all industries? Join us as we unravel the secrets to building trust with our exceptional guest, Corey Sheer, founder and CEO of TrustCentric Consulting. Corey shares his journey and research on the structure of trust, and reveals the three vital building blocks that can make or break trust within an organization: organizational competencies, problem-solving skills, and demonstrating care for others.

Dive into the world of trust with us as we examine the importance of making trust a key performance indicator (KPI) to become more strategic. Corey highlights five critical priorities for organizations seeking to build trust: regular employee feedback, honest conversations, a clear strategy, transparency, and clear ownership of tasks and projects. We explore how prioritizing these elements can help create a culture of trust and the impact of a lack of trust on key performance indicators like employee productivity, retention, loyalty, and advocacy. Corey even shares some practical advice for leaders eager to start rebuilding trust in their organizations. Don't miss this insightful conversation that will help you transform your organization's trust landscape!

Are you a Type A personality?  Discover how our guest, a fellow Type A individual, managed to transform their career journey to find meaning and fulfillment in their work. We dig deep into the need for variety and engagement for easily bored Type A personalities, the impact of early childhood experiences on our tendencies, and the role societal influences play in shaping our career choices. Plus, we reveal how understanding our coping mechanisms is essential to finding a career that truly works for us.
  
  Feeling trapped in a role that doesn't suit your personality?  Find out how to self-assess what you're tolerating and not accepting in your life, and how making small decisions can help shift your experience for the better. We also discuss the significance of being aware of your emotions throughout the day, so you can reach that tipping point where it becomes less painful to make a change than to stay stuck in a lane that doesn't work for you. 

What if there was a way to revolutionize musculoskeletal care while reducing unnecessary procedures? Discover how Dr. Michael Greiwe, founder of OrthoLive, is using telemedicine to ensure patients receive the right treatment. In our engaging conversation, Dr. Greiwe shares his journey from medical school to creating OrthoLive and the importance of listening to patients' stories in making informed diagnoses. 
 
 We also explore the power of shared decision-making in healthcare, empowering patients to become informed and communicate with their physicians for better compliance and outcomes. Learn how coming together and creating a plan benefits both patients and physicians while potentially transforming the way we approach musculoskeletal care. Join us as we discuss the future of OrthoLive as a network of surgeons providing efficient and cost-effective healthcare solutions.