This episode of The ShiftShapers Podcast is called “The One Thing Holding Your Business Back” with Ed Krow, Founder & HR Strategist of Ed Krow, LLC. Today, Ed explains that businesses need to adapt to the Experience Age to manage their employees better.

He also shares that businesses can achieve their next big milestone by letting others make the difficult decisions for them. Not only does this boost creativity to run a business, but it also fosters trust in the company culture moving forward.

What You’ll Learn From this Episode:

  • 01:27 What is an HR Strategist?
  • 04:25 Doing business in the Experience Age & adapting to it
  • 11:39 Regaining creativity & inspiration by letting go
  • 17:24 Creating an ideal business environment by asking questions

Quotes:

02:25 “Let’s breakthrough that barrier. You want to get from 10 to 15 million? People are going to get you there. You want to get that new product to market? People are going to get you there.”

04:25 “We’re in the Experience Age now. And what I mean by that is, if you want to harness the power of what’s going on in your company, then you have to recognize that your people are living their lives in and through social media.”

07:51 “You will never break through that ceiling until you change how you’re going to do business. If you’re willing to flip that key, we can make it happen. We’ll get you to 15 million.”

18:14 “How can you know that you’re giving your people what they want if you never ask them?”

20:54 “Ask your people what they want. And they’re afraid to ask because what if I can’t give it to them? Then we’ll go that road if we can’t do it. But if you don’t ask, you’re going to spend money you don’t need to spend.”

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This episode of The ShiftShapers Podcast is called “You Can’t Be A Thought Leader In One Day” with Andrea Pass, founder and CEO of Andrea Pass Public Relations. Today, Andrea shares what it means to be a publicist and how thought leaders are created using the free tools available to public relations.

Andrea also discusses the relevance of PR with social media and how she applies the traditional PR methods to keep her clients up to date in the digital world. She also provides actionable tips for businesses in employee benefits to get started on their own PR.

What You’ll Learn From this Episode:

  • 01:57 What is a publicist?
  • 04:56 Publicity as an ongoing process
  • 10:18 Defining the role of social media in PR
  • 14:49 Reactive and proactive PR for insurance brokers
  • 20:16 Andrea’s tips to create PR relationships for employee benefits

Quotes:

05:43 “Publicity is an ongoing process. It’s not a one and done. And you want to stay relevant because you want to have interviews all of the time about your business, your service, your product, your book.”

11:04 “I believe that social media is important and should go hand in hand with a public relations campaign because of the fact that you want to drive more awareness to your social media pages.”

20:44 “To find that business writer at your local publication, to shoot an email and say okay, here I am. This is what I do, short little paragraph, and here are 4 bullets of topics I can talk about.”

21:01 “The most important thing for your audience in insurance is making sure that you’re in touch with your major compliance department to make sure you have the ability to do public relations on your own without going through corporate.”

21:23 “If you are not working for a large organization and you can get out there on your own and talk about things because the other guy can’t, now is the time to start public relations.”

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This episode of The ShiftShapers Podcast is called “New Developments In Pharmacy Cost” with Garrett D’Antoni of NavRx, a prescription benefit manager (PBM) with a commitment to transparency.

Garrett begins by defining companion diagnostics then breaks down the confusing nature of NDC codes and why some PBM’s can charge astonishing amounts for prescribed medications. He also goes into detail about the increasing popularity of pharmacy tourism and the significant cost savings it offers.

What You’ll Learn From this Episode:

  • 02:50 Providing expensive drugs with companion diagnostics
  • 06:15 NDC codes explained
  • 13:00 Generating massive savings with pharmacy tourism & prescription care coordination
  • 18:20 The future of pharmacogenomic testing & PBM’s

Quotes:

05:17 “There’s not enough drugs that are mapped genetically that says okay, this is how you’re going to metabolize it. And so, as we move towards that, you’re right, it comes down to do I take it or do I not take it?”

08:24 “This is where the spread pricing comes in. So a pharmacy could submit one NDC, the PBM can charge a client on a different NDC, so you’re basically switching the NDC from one price to another.”

09:21 “You have to get the information. That’s the most difficult part when you go to a PBM and say, well, let me see what you actually paid the pharmacy. Is that what you billed me? And so that’s when they’re saying it’s proprietary information.”

11:35 “You have the polytherapy problem where the one drug causes your stomach ache so they put you on another drug. And before you know it, you’re on five different medications.”

15:55 “You have these countries that you’re getting up to 50, 70 percent discount on the medication. You’re traveling there three to four times a year. You’re bringing back basically 90 days supply. And you’re able to keep some coordination or continuity of care.”

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This episode of The ShiftShapers Podcast is called “Thinking About Starting A Podcast” with Elzie Flenard, Founder of audio marketing agency Enterprise NOW! and The MAYOR of Podcast Town, a community for podcasters by podcasters.

Elzie shares what makes a successful podcast, from having the right motivations and mindset, to the more technical aspects behind producing a show flow, post-production, and the CRAB process which stands for Compose, Record, Arrange, and Broadcast.

What You’ll Learn From this Episode:

  • 03:52 Podcasting as a business
  • 05:08 Laying the groundwork for your own podcast
  • 08:12 Podcast success: The right mindset & consistency
  • 14:53 Post-production, the CRAB process & show notes

Quotes:

04:09 “Podcasting is a fantastic way to build and cultivate relationships. It’s also an awesome way to get to know people and to really just cultivate those connections that are made through the process.”

07:13 “Once you develop your why, now you go into planning your strategy. What types of people do you want to talk to? What do you want to talk to them about and having that listed in your show flow?”

13:49 “A general rule of thumb is a 1 to 4 ratio. Let’s say it’s a 30-minute show, it’s probably going to take you 4 times that total to do all of the things. The editing, the graphics, the social promotion, the research.”

18:10 “We have what I call the CRAB process. That just stands for Compose, Record, Arrange, and Broadcast.”

20:06 “I think as a listener, it’s important to give a summary of what the episode is about and maybe a couple of highlights and bullet points on key insights or things that have been talked about during the show.”

Resources:

https://www.enterprisenow.net/

[email protected]

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This episode of The ShiftShapers Podcast is called “Direct Primary Care In the Employer Market: How To Get There” with John Collier, President and CEO at Proactive MD, a direct primary care (DPC) organization.

John explains the possibilities of DPC that integrates administrative processes, delivers clinically effective healthcare while still remaining financially viable for stakeholders, and promotes patient empowerment through a “patient advocate”.

What You’ll Learn From this Episode:

  • 03:58 How to make DPC widely accepted by employers
  • 07:33 Creating a system that streamlines administrative processes
  • 10:46 Making DPC attractive to physicians & employers alike
  • 16:47 The role of the Patient Advocate to engage & empower

Quotes:

04:59 “Truthfully, while they’re great phenomenal physicians that I’m sure they have incredible clinical outcomes in their DPC practice, they don’t fully understand the business case for what a self-funded employer is facing.”

07:51 “At its core, direct primary care was invented and built to reunite a patient and a physician relationship, in a partnership.”

08:22 “If we’re solely focused on the patient and what is right for that patient, let’s leverage that data to help them take this patient by the hand and walk through the care continuum as primary care was designed to do.”

15:41 “When direct primary care physicians and these groups are working with employers, the care doesn’t stop at that on-site clinic.”

18:15 “The care team would consist, and they would be partners with that physician, is a licensed clinical social worker that’s going to work with the physician to engage a population.”

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This episode of The ShiftShapers Podcast is called “Target and Tame the Drug Spend Monster” with Pramod John, Founder and CEO at VIVIO Health. They discuss the changing nature of specialty drugs as adjuvant therapies and the skyrocketing costs that come with it.

Pramod also discusses the case of Humira biosimilars and AbbVie’s threat to litigate, resulting in it being unavailable in the US. He further explains the broken system that favors big pharma, its detrimental effect on regular citizens, and what we can do about it.

What You’ll Learn From this Episode:

  • 03:31 Growth of specialty drugs & adjuvant therapies
  • 06:16 TNF inhibitors, Humira biosims & AbbVie’s threat to litigate
  • 13:25 Why do Americans pay more for specialty drugs?
  • 19:29 Standing up against unfair pricing

Quotes:

06:08 “If you can put them on adjuvant therapies, whether it extends your life or not and no one’s paying attention, it’s a huge moneymaking machine for pharma.”

07:59 “Humira’s biosim is not available in the US market because AbbVie has threatened to litigate against the 5 manufacturers or 6 manufacturers of biosims.”

16:33 “The government failed because the government has neither price controls to say look, you can’t just charge a bazillion dollars because you want to.”

19:14 “Manufacturers can charge insane prices for a drug that no one else in any part of the world will pay because we’re concentrating more and more dollars from larger and larger number of people into a smaller and smaller number of people.”

21:23 “Until the American people say we’ve had enough to the politicians and everyone else, it’s very difficult to change these things economically because you’re fighting against monopolies.”

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This episode of The ShiftShapers Podcast is called “Creating a Fee-Based Consultancy” with Derek Winn and Jessica Du Bois, Consultant and Employee Benefits Advisor respectively at Business Benefits Group. They talk about the differences of Distilled Concepts from the parent company and how this new division caters to the specific needs of their clients.

Some of their innovations include leading with an RFI before sending a project proposal to fully understand who their client is and what it is they want to achieve, and letting the clients come to them instead of focusing on inbound leads.

What You’ll Learn From this Episode:

  • 05:47 Distinguishing Distilled Concepts from Business Benefits Group
  • 07:28 Letting the clients come to you
  • 13:23 Offering a menu of services & thought leadership
  • 17:31 Providing clients an unforgettable user experience

Quotes:

03:59 “Let’s get to 12, 15, 20% year over year. What are the things that need to happen in order to do that when it comes down to retaining clients, finding new clients, finding new ways to be able to help serve them?”

07:07 “Let’s lead with the distilled, clean, pure ideas, the proven concepts that can help to produce results but also at the same time remain agile in the market.”

12:48 “What else do I need to change in a process of exiting a PEO? If it turns out that leaving the PEO is the best option for that client, then yeah, we’re happy to support them afterwards.”

14:30 “Having an upfront, decided upon fee schedule based on the work you’re providing, that’s one of the big takeaways for other brokers to think about.”

20:40 “As much as we go into those conversations and we’re competing with the large consulting houses, we can also go in and complement them as well.”

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This episode of The ShiftShapers Podcast is called “The $500 Tipping Point” with Amy Chambers, Founder and COO of HealthBridge. Today, David and Amy discuss the complex problem of providing for the healthcare of the functionally uninsured.

Amy explains their program’s benefits to providers such as infusing cash into the system and reducing difficulties in collecting. On the member side, she further shares how this restores their dignity around the issue of money and their faith into value-based care.

What You’ll Learn From this Episode:

  • 01:55 Amy’s background & observations on average American financial capacity
  • 08:52 Designing a program for the functionally uninsured
  • 13:49 Advantages to providers
  • 17:02 Benefits to employee members

Quotes:

04:54 “The average plan out of pocket these days is $8,000 but the average American has about $400 in times of emergency.”

05:42 “64% of people report to have avoided medical care due to these out of pockets. That’s meaningful and it impacts outcomes. It erodes what we’re trying to do in value-based care.”

11:49 “What we’ve created is a first of its kind employee benefit program. It’s going to help the member regardless of their financial status because we talk about a lot of people who are lower income.”

14:23 “We cover all the co-payments, co-insurance, and deductibles for them, all the way up to their out of pocket and beyond if they happen to have any co-pays.”

17:08 “It certainly insulates them against financial crisis. It should arguably improve their access to care. About 25% of those members that you’re sitting knee to knee with in open enrollment actually have no access to credit.”

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This episode of The ShiftShapers Podcast is called “Removing Self-Funding Barriers For Employers and Advisors” with Michael Poelman and Spencer Brydon, President and Regional Vice President of Sales respectively at Novo Benefits.

Today, Michael and Spencer discuss what keeps employers and brokers from going self-funded, as well as what independence and transparency really mean in this space. They also share how brokers can approach stop-loss carriers and reduce complexity moving forward.

What You’ll Learn From this Episode:

  • 01:46 Barriers to becoming self-funded: Perceived risk & complexity
  • 05:49 True independence & transparency
  • 10:26 Pros & cons of different avenues to a self-funded plan
  • 12:27 Talking to a stop-loss carrier & reducing complexity
  • 18:01 The present & future roles of technology

Quotes:

03:14 “Jumping into the TPA realm or vertically and they go to TPA, they tend to see those complexities are worked out because they’ve already prefabbed whatever they’re getting.”

13:48 “A traditional broker might just go out there and market stop-loss but they’re not really again able to get the stop-loss markets to respond with rate discounts that are appropriate for what you’ve put together.”

17:52 “They oftentimes come to us with 1 solution and when they realize that the other solutions might have more to offer, they oftentimes trade up in the sense.”

18:58 “As we start to introduce AI and machine learning into the process, we’re making it much easier to be able to create customized plan stacks that are targeted at a specific population.”

20:19 “If you’re building a plan just based off of a census, you don’t have very much insight, if any at all, into what’s actually going on behind the scenes.”

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This episode of The ShiftShapers Podcast is called “Using Data To Decide When To Go Partially Self Funded” with Hari Sundram, CEO and Founder at Verikai. Today, David and Hari discuss the kinds of data that are used as a surrogate for risk.

Hari explains how brokers can inform their clients on predictive modeling and how having large data sets helps cut through anecdotal biases to provide new premiums and new outcomes.

What You’ll Learn From this Episode:

  • 01:27 The right time to go self-funded
  • 04:32 Data as a surrogate for risk
  • 09:36 Data analysis: How brokers should inform clients
  • 16:14 Predictive modeling: Creating new outcomes with repetitive data

Quotes:

07:45 “Ultimately, the outcome we try to look at is loss ratio applied at an individual level. That’s our goal because ultimately that’s the lynchpin of understanding whether the group has the risk necessary.”

11:19 “When you get back that score, a scenario analysis is laid out for you that says this is a score and this is how it translates into the placement of the business.”

18:24 “The only thing more dangerous than no information is a little bit of information because with a little bit of information, you’re able to apply your bias even more than with no information at all.”

21:30 “The value of predictive modeling is its ability to cut through those things that are anecdotal and find pattern that have occurred historically but have occurred historically repetitively.”

24:41 “If you want to write new premium, you need new information. What you want to do though is make sure that that new information does actually index to the outcome because the outcome is actually consistent.”

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