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We challenge the habit of postponing healthcare decisions and explain why waiting almost always makes costs and outcomes worse. We walk through a simple business analogy and a real client example that shows how access to care changes the entire claims story. 
• leadership teams seeking certainty and choosing delay 
• why healthcare trend compounds when nothing changes 
• the 15% cost increase analogy and accountability 
• large claims as outcomes rather than root causes 
• “front door” access problems like low primary care connection 
• preventive care participation and ER-first behavior driving costs 
• the mindset shift from insurance to healthcare 
• catching chronic conditions early to avoid catastrophic claims 
What healthcare decision are you postponing? 

Music by Alex Lambert.

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Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

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We get fired up about why healthcare costs keep climbing and zoom out to the two foundational incentive problems that distort pricing. We connect the dots between insurer profit math, PBM ownership, and a real pharmacy cost example that shows how much money employers can waste without the right partners. 
• the 15% profit margin cap and why percentage-based profit can reward higher premiums 
• the missing incentive for insurers to push costs down in a truly competitive market 
• vertical integration and bundled healthcare services that function like monopolies 
• PBM ownership links between Express Scripts, OptumRx, CVS Caremark, and major insurers 
• why pharmacy benefit management often shows up as the most profitable line item 
• a real employer example of $140 vs $70 per member per month pharmacy spend 
• choosing better healthcare partners to reduce waste and improve cost transparency 

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

We build on the idea of direct primary care as the front door to healthcare and connect it to a surprisingly simple place to save money fast: routine lab work. We unpack why common tests get billed at hundreds of dollars when the real cost can be around $15, and we challenge employers to rethink what they are truly paying for.  
• Using direct primary care to steer members to the lab of our choice  
• Incentivizing lab behavior by making partner labs free  
• Breaking down real costs of common tests like CMP and A1C  
• Explaining how facility fees and middlemen inflate billed charges  
• Creating a win for patients, employers, and labs through direct payment  
• Asking whether routine labs buy healthcare or healthcare administration

If you care about employer healthcare benefits, healthcare transparency, and lowering healthcare spend without cutting care, you’ll get practical ideas you can act on. Subscribe, share this with a benefits-minded coworker, and leave a review. Are your employees buying healthcare or buying healthcare administration?

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Cancer can take everything fast and that reality hits hard. Today we talk candidly about why cancer is still one of the biggest drivers of employer health care spend, and why the most expensive mistake a company can make is treating “cancer strategy” as something that begins after diagnosis. When we wait for a claim to appear, the plan goes into response mode: treatment starts, specialty drugs show up, costs climb, and employees face the physical and emotional toll along with time away from work.

We challenge the assumption that the biggest cost story is only about GLP-1s or specialty meds. Drugs matter, but they’re only a portion of total plan spend, and focusing there can hide a bigger opportunity: preventing late-stage cancer diagnoses through better screening behavior. We walk through the practical questions employers should be asking years earlier, like whether employees are getting eligible cancer screenings, scheduling annual physicals, and keeping up with routine care that can catch problems sooner.

Then we get concrete. We explore two levers that actually change behavior, education and money, and why you often need both. We share a simple idea any CEO or HR leader can test: offer a $100 reward for proof of an eligible cancer screening, and let word-of-mouth do the rest. We also run the math on early-stage versus late-stage cancer costs and explain why even one earlier catch can justify a surprisingly large prevention budget. If you care about outcomes, culture, and controlling health plan costs, this is the kind of benefits strategy that can change lives. Subscribe, share this with an HR leader, and leave a review with your take: would an incentive like this work at your company? Is it worth trying?

Music by Alex Lambert.

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Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

A referral can feel like help, but when you’re the one making the calls, waiting weeks, guessing at quality, and praying the bills “make sense,” it’s not coordination, it’s homework. I’m Justin Futrell, a benefit advisor at True North Companies, and I’m digging into what happens when primary care isn’t enough and the stakes move from routine care to specialty care.

I walk through a simple migraine example to show two very different paths. One is the familiar “good luck” referral where you search on your own, hope the specialist is in network, and hope the care is actually high quality. The other is what direct primary care and concierge health can do when it’s working at its best: an independent primary care relationship that knows the specialists they trust, understands outcomes, and can guide you to the right next step like a vestibular therapist or another specialist who can actually move the needle.

We also talk openly about incentives. If urgent care is owned by a hospital system, how often do you think they send patients to a competing system, even when it might be a better fit? That’s why employer-provider partnerships matter, especially for self-funded employers that can contract with transparent, collaborative, accountable surgery centers, imaging facilities, and specialty groups so employees aren’t entering specialty care blindly.

If you’ve ever wondered who should choose your specialist when it really matters, this is for you. Subscribe, share with a coworker, and leave a review if you want more practical breakdowns like this.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Most benefits conversations start with the renewal. I want to start somewhere else: the moment an employee actually needs care and has to figure out where to go, who to call, and how long they’ll wait. That is the “front door” to healthcare, and if it’s broken, no amount of clever insurance math fixes the experience.

On a trip to Springfield, Missouri, I spot something that stops me in my tracks: a building tied to Bass Pro Shops offering primary care and urgent care. When I look closer, it’s a dedicated clinic built for covered employees and their families with primary care, preventive care, chronic condition management, health coaching, a pharmacy, and virtual care. It’s a clear signal that some employers are shifting their benefits strategy from healthcare financing to healthcare access.

From there, I lay out two routes. Route One is what most people live with today: weeks to get in, scattered providers, hard care coordination, and bills that show up months later. Route Two starts with an accessible primary care relationship where someone knows your name, you can get same-day appointments, visits are long enough to matter, and you get navigation when specialty care is needed. That is how we move from an emergency response system to a health maintenance system.

If you’re an employer, HR leader, or benefits decision-maker, this is an invitation to think like a healthcare architect and ask what path you’re putting your people on. Subscribe, share this with a colleague, and leave a review with your biggest healthcare pain point so we can tackle it next.

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

I compare today’s healthcare experience to moving to a city with no signs or maps and explain why that confusion keeps people from getting care. I share a real data point showing 57% of members skipping preventive exams and argue for a better front door led by a trusted physician. 
• the “no directions” problem in healthcare navigation for employees 
• why people with insurance still delay care 
• what 57% missing preventive exams signals for long-term risk 
• how late care can turn stage one into stage four 
• the burden of finding in-network care, scheduling, follow-ups, specialists and bills 
• why a trusted primary care physician can guide decisions and improve outcomes 
• the employer question that matters most: do employees have a front door to care 
Let's talk more next week. 

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Healthcare costs keep climbing because utilization is rising and high-cost drugs are changing the baseline, not because of a one-time post-COVID bump. We break down what the end of enhanced ACA subsidies means for the individual market and why employers feel the pressure next. 
• employer-sponsored health plans facing 8% to 9% cost increases 
• inflation not the only driver, with wages and hospital consolidation raising costs 
• higher utilization as the lasting shift, including more screenings and more prescriptions 
• specialty drugs and new therapies reshaping pharmacy spend, including GLP-1s and gene therapy 
• ACA subsidy expiration triggering major premium spikes and more uninsured people 
• tighter individual market making employer coverage more critical 
• cost shifting dynamics that will hit employer plans 

What can employers do?

Practical employer moves, including challenging renewals and reviewing loss ratios. Focus on value through utilization management and a clear pharmacy strategy. Curious to explore what's possible? Let's connect. 

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

Gene therapy can cure diseases that once felt untouchable, but it can also trigger the biggest claim a self-funded employer may ever face. We focus on the hidden costs around the drug, why network contracting matters, and how transparency and preparation protect the health plan when rare cases hit.
• Gene therapy risk for self-funded employers beyond the drug price
• Hidden cost drivers like hospital stays, administration, and follow-up care
• Contract loopholes and vague network terms that inflate total allowed cost
• Why specialized gene therapy networks can run cheaper on average
• The real-world math on how often gene therapy and transplant cases occur
• Preparing for financial earthquakes with better planning and transparency

The urgency that gene therapy is already here, not years away. Let me know if you want to discuss how to get more control of your outstanding risk. 

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits. 

Send us Fan Mail

We unpack the shock of multi-million-dollar gene therapies and why a one-time cure can collide with a self-funded plan’s budget. We explain in vivo versus ex vivo approaches, where care happens, and how employers can think about coverage choices and preparation.

• the cost reality of one-time gene therapies 
• who pays on a self-funded plan 
• tradeoffs of excluding versus covering therapies 
• why centers of excellence matter 
• differences between in vivo and ex vivo models 
• examples including hemophilia and sickle cell 
• operational needs for case management and stop-loss 
• a preview of hidden employer risks next week

Music by Alex Lambert.

Support the show

Contact Justin via text 740-525-5259 or via email [email protected]

I welcome the opportunity to hear your feedback from this episode!

Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.