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Dr. Marc Grossman, Founder and CEO at PriceMDs, has a unique 30-year perspective on the industry, having spent time as a surgeon, an administrator and a hospital owner. Over that time he has developed a keen sense of the chaotic and often adversarial pricing system that is prevalent in today’s medical and insurance industries.

He believes that “Episode Of Care” pricing for non-emergency procedures can help all constituencies operate in a more intelligent, effective and efficient manner, while driving significant cost savings without sacrificing quality of care or outcomes.

What You’ll Learn From this Episode:

  • How did the current state of pricing become so chaotic?
  • What is “Episode of care” pricing
  • Is it important for patients to know the costs up front (spoiler alert: the answer is not) what you may think).
  • How do you drive understanding, employee engagement and employer take up?
  • Can offshore medical facilities also play a role?

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Bob Gearhart Sr. and Bob Gearhart Jr. – known simply as “Senior” and “Junior” (or “The Bobs”) to their clients and friends – have found the formula for a highly successful multi-generational agency. Combining a depth of knowledge and an application of technology, they have built a next-generation agency that keeps it simple.

They believe that as the industry has become more complex, clients really want simple explanations and clear pathways to their goals. They have taken another leap and put their fees at risk, which they feel puts them on the same side of the table as the client. Learn how they do it on this episode of ShiftShapers.

What You’ll Learn From this Episode:

  • How do you handle the complexities of today’s market?
  • What is health care chain management?
  • How can advisors reframe correctly who is driving costs?
  • What are the four strategic areas they focus on?

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Many of us make personal resolutions at the new year, but corporate resolutions can be an even more powerful way of keeping your eye on the big picture during the coming business year. Amy Evans, President of Colibri Insurance writes annual resolutions for her firm, but she goes a step further – she publishes them!

We caught up with Amy to discuss her feeling that this is a key part of her agency’s success. We explore last year’s list and the impact it had on her practice and we chat about this year’s resolutions, too. It isn’t too late for you to make your firm’s resolutions for the New Year. Listen in and learn from Amy.

What You’ll Learn From this Episode:

  • What’s the difference between a goal and a resolution?
  • How many resolutions make sense and when are you going overboard?
  • How you can keep the resolutions list high-level, but practical
  • How to assess your business’ success during and at the end of the year

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Mark Gaunya and Jennifer Borislow continue their discussion from last episode about why healthcare is so expensive and share their ideas to slow rising prices. With the release of the second edition of their book Bend the Healthcare Trend, Mark and Jennifer are advocating for consumer-driven healthcare as the solution to rising expenses.

In analyzing the healthcare system, inflation greatly outpaces the general economy. Our guests explain why the industry’s prices rise so much faster than those of other industries, largely due to a lack of transparency or tangible competition.

Opportunity will grow from greater industry transparency and responsibility, as consumers will save money and maintain better health. We need to look beyond physical health and appreciate mental, spiritual, and financial health as well.

What You’ll Learn From this Episode:

  • The three essential principles of healthcare’s oncoming trend: Transparency, Responsibility, and Opportunity.
  • Why healthcare is the only industry where consumers don’t shop around.
  • What opportunities flow from responsibility and transparency.
  • The difference between wellbeing and wellness.
  • Why there has been an uptick in interest around self-insured plans. 
  • How companies of all shapes and sizes can approach a self-funded health plan, and how an advisor can approach that conversation.

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Nine years ago, Mark Gaunya and Jennifer Borislow wrote “Bend The Healthcare Trend” to explore how healthcare consumers could counteract the damaging effect of a system with misaligned incentives, opaque pricing schemes, and unnecessary complexity. They are about to release the 2nd edition of their definitive book and ShiftShapers talks to them about how much has changed; and how little has changed!

The authors believe that what has not changed is that consumerism and transparency are still the answer to an industry that remains unnecessarily confusing, even for many folks within the industry. The average layman stands no chance in a system created by the rule makers, for the rule makers.

Our guests lay out how the government, Big Pharma, hospital systems, and health insurance companies are incentivized to stop price deflation and maintain complexity.

The second edition is peppered with actual examples of how they have used the principles in the book with their clients – and the success those clients have enjoyed in gaining control over their plans while delivering a climate of health and well-being for their employees.

Mark and Jennifer also outline what has changed since the first time they wrote about consumer-driven healthcare in 2009. The lack of transparency in the market is still an issue, but organizations are starting to deliver tools that aid consumers in making choices.

What You’ll Learn From this Episode:

  • What prompted the first edition back in 2009
  • What has changed since then and why update now amid the unsettled environment
  • Have we made progress in consumerism since 2009
  • What will it take to de-isolate consumers from the cost of care
  • Cost is the third rail. Why won’t politicians deal with it
  • The three principles: Transparency, Responsibility and Opportunity
  • What is the difference between wellness and well-being
  • Do we need to create a higher level member experience
  • Why the uptick in interest about self-insured plans
  • How can small and mid-size firms self fund and how does an advisor begin that conversation

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Twenty million Americans are employed by firms with 20 or fewer employees – many of which do not provide health care coverage for their employees. Josh Hilgers, Director of Enterprise Sales at Quotit says that despite all the usual excuses, the “21st Century Cures” Act signed two years ago is offering those employees and employees options while creating a huge opportunity for benefit advisors.

Josh is one of the organizers of a free virtual conference called the “Benefit Success Summit.”  Shiftshapers is participating, along with a number of other thought leaders and practice shapers. Click the link below for more information about how you can sign up.

What You’ll Learn From this Episode:

  • How the Act created QSEHRAs
  • What you can do with a QSEHRA from a defined contribution platform
  • Why this is amazing opportunity to serve an often overlooked market
  • How this can help <20 employers attract and retain top talent

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In Part 2 of this 2-part episode we will ask David Contorno, President of Lake Norman Benefits and Benefit Selling’s 2015 Broker of the Year about Performance-based Compensation and his belief that it puts advisors in a much better long-term position.

Forbes Magazine called our guest, David Contorno, one of America’s most innovative benefits leaders. As he works with clients and travels the country consulting with prospects and other advisors, he has come to the conclusion that if you use today’s tools and techniques in a whole-benefits strategy, the best model to differentiate yourself is with Performance-based Compensation.

We explore that concept – what it is and what it is not – and it helps advisors deliver a better overall experience for clients while helping to drive significant non-product revenue to their practices.

What You’ll Learn From this Episode:

  • What performance-based compensation is and it’s advantages
  • Where the concept can be applied in our industry
  • The value-adds that can drive PBC, and what is more important than costs
  • How to achieve demonstrable, repeatable ROI

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Forbes Magazine called our guest, David Contorno, “One of America’s most innovative benefits leaders.” So, what’s he up to and what tools, techniques and strategies is he bringing his clients? We discuss why the “old way” just isn’t working and how this leads employers to a dilemma. We also explore whether the advisor community is moving to a completely different delivery model.

David explains why talking to the C-Suite is the way to provide 21st-century advice to clients. We chat about how rationing of care has changed and how it has moved the industry and what questions advisors need to ask their clients. (Spoiler alert: those questions are VERY different than the traditional conversation).

What You’ll Learn From this Episode:

  • Why the old way isn’t working when it comes to the way we deal with benefits
  • The employee benefits see-saw and what that means to their well-being
  • Rationing of care and why it’s a real problem
  • Is CDHP a real thing that makes a real difference
  • The role of real ROI and what questions we need to ask

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On this episode of ShiftShapers, we are stepping out of the realm of employee benefits, insurance and financial planning to discuss the ultimate differentiator for all businesses – customer service. Peter Shankman is the author of a new book, Zombie Loyalists: Using Great Service to Create Rabid Fans.

As an international consultant, serial entrepreneur, angel investor, corporate speaker, founder of Help A Reporter Out and The Geek Factory, Peter knows how to create zombie loyalists and why they are key to your success. As parts of our business become more commoditized, Zombie Loyalists can be the secret weapon that will help to build and sustain your business.

We begin by asking Peter a question we never thought we would ask anyone on the podcast. Peter explains how to create zombie loyalist embryos and how to feed and care for them as they turn into single-minded advocates for your practice. We also chat about how you can lose their loyalty and what to do when that happens.

All of us at ShiftShapers thank you for you continued support. We hope you enjoy holidays with family, friends, great food, and this encore episode:

What You’ll Learn From this Episode:

  • Peter’s background as a serial entrepreneur.
  • Why he chose to use the word “Zombies” in his book.
  • How a jacket and an airplane trip crystalized an idea.
  • How you can incubate, care and feed your Zombies.
  • How your business can create small instances of personalized “Wow!”

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Although the concept behind Direct Primary Care (DPC) is more than 10 years old, more and more physicians are opting out of the insurance-based world for a practice model that is old-fashioned but in the best sense of the word. Our guest on this episode – Dr. Jeffrey Gold – explains the attraction from the physician side of the equation.

What You’ll Learn From this Episode:

  • Why patient experience is a key driver of DPC popularity.
  • How some take up differentials are regional.
  • Why DPC is like the old “family doctor” relationship.
  • How physicians practice medicine instead of insurance.
  • Why ensurance is more important than insurance.

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