This episode of The ShiftShapers Podcast is called “What is Stress – and How Can We Cope? – With Lynn Jonen, PhD” and today, host and Chief Transformation Strategist David Saltzman and Lynn discuss the problems caused by stress, understand the underlying causes, and explore various solutions.
This discussion is especially relevant nowadays with the drastic changes brought about by COVID-19 and the corresponding stress that it causes on people. David and Lynn also talk about spiritual health and its role in keeping stress at bay.
What You’ll Learn From this Episode:
02:26 Defining stress responses
06:59 Managing stress
15:55 Techniques to intervene and control stress
18:33 The significance of spiritual health
21:09 Social distancing: shifting from physical distancing to social connection
Quotes:
09:33 “They can make you increasingly more vulnerable to the ill effects of stress which tend to be more illness with lower immune function, more digestive problems, reproductive difficulties, difficulties with higher-level cognitive thinking.”
12:53 “It does have, when stress is good, if you’re at work and you have a big project or a presentation, a little bit of adrenaline can help sharpen your thinking and focus.”
14:50 “Stressful events are stressful because the individual perceives them that way.”
17:27 “Meditation and mindfulness are so popular because they ask that we focus on the present moment at the exclusion of future worries and past regrets.”
20:20 “Prayer is a wonderful way to manage stress and feel that connection, creativity. Looking at your values, looking at your sense of meaning and purpose in life and maybe talking to someone, seeking support when you need help sorting that out.”
This is part 2 of The ShiftShapers Podcast episode called “Reading the Regulatory Tea Leaves – with Jessica Waltman” and today, host and Chief Transformation Strategist David Saltzman and Jessica discuss transparency changes on the regulatory front and how these changes can affect you and your clients.
In particular, Jessica breaks down into plain language the transparency rules that affect hospitals and the differences with the rules for insurers and employer-sponsors in disclosing information. Jessica also explains how the new rules affect regular consumers and how requests for information can be made.
What You’ll Learn From this Episode:
02:17 Transparency rules: 1 enforced & 1 pending
04:49 Hospitals to make their rates public: online & list of common services
09:00 Transparency for insurers, employer-sponsors & plans
13:42 Ceding liabilities
Quotes:
04:02 “The hospitals have sued the Trump administration over this rule and they are trying to stop it from being implemented.”
05:27 “It’s really looking at what’s the hospital take-home for these services. It’s not really looking at what you or I might pay if we went into the hospital.”
09:12 “What the employers and the insurers are going to be asked to do is they have to disclose the price to consumers. They have to make it available.”
13:42 “If you’re a fully-insured regular small group of 20, you have liability but you can cede your liability to your carrier via your contract.”
14:28 “In a self-funded scenario, the ultimate liability for this getting done as proposed rests on the employer-sponsored plan.”
This is part 1 of The ShiftShapers Podcast episode called “Reading the Political Tea Leaves – with Jessica Waltman” and today, host and Chief Transformation Strategist David Saltzman and Jessica discuss health insurance and health-related matters in today’s political climate.
Jessica, who is Principal at Forward Health Consulting, provides easy to understand insights about what is happening with the Affordable Care Act or ACA and how scrapping it affects much more than just Obamacare. She also provides a fearless forecast on the future of the ACA under a Sanders, Biden, and second Trump administration.
What You’ll Learn From this Episode:
02:21 Supreme Court to rule on the ACA
10:57 Separating Obamacare from ACA
14:22 Predicting healthcare in the next administration
Quotes:
07:08 “So we’re going to hear one hour of arguments and you’re going to have to bring these issues to us. One, is this challenge to the ACA even legal at all?”
08:07 “And then three, if it is true, and the mandate’s invalid, then can it be separated from the rest of the ACA or should the entire law be struck down?”
11:16 “The part that everybody talks about, things about as Obamacare, is really about 50 pages in the front. So it’s not really that big.”
16:01 “Bernie Sanders wants to have a single-payer system in the United States. He wants everyone to have free healthcare with no co-pays, no premiums.”
20:34 “My guess is that Joe Biden, having his very long legislative history and then also serving as vice president, is a little more flexible than perhaps Bernie Sanders.”
This episode of The ShiftShapers Podcast is called “Innovation and Problem Solving, with Jayne Morgan, M.D.” and today, host and Chief Transformation Strategist David Saltzman, together with Jayne, Director Of Innovation at Piedmont Healthcare, discuss innovation and how it is applied at Piedmont.
Also discussed is diversity in clinical trials; why it is lacking and the progress of making it more inclusive to more minorities. The role of the FDA is also clarified when it comes to making changes in addressing health gaps and producing solutions that affect all demographics of people.
What You’ll Learn From this Episode:
03:02Accelerator and devices at Piedmont
07:13 Digital-based innovation and ongoing projects
09:50 Process of innovation from concept to implementation
13:12 Diversity in clinical trials
17:38 Role of the FDA in clinical trial diversity
Quotes:
07:30 “We will be starting with hospital-based problems and systems, looking at process improvement… inventions that address specific pain, one’s within the hospital-system itself, inventions that perhaps can be a jump to some of the internal apps that we already currently use.”
10:03 “If you don’t have the fortitude, I would say that that is probably one of the largest factors that contributes to that large failure rate, is that people are not clear on what they’re getting into and what the time commitment is.”
13:54 “Access to clinical trials traditionally, and certainly in the United States, has not been something that has been readily available to minority communities. And there are a number of reasons for that. Number 1 reason is probably trust and trust in the system or lack thereof.”
16:59 “As we move forward into personalized medicine and customized medicine, genome mix, by whatever term that you know it, is we do not participate in trials and have a plethora of participation that represents a swathe across all of America, indeed across all of the world.”
18:03 “Now, unofficially, the FDA is continuing to move in that direction and more forward-thinking institutions are also beginning to move in that direction such that we can ensure that the health disparities, the health gap in these countries, don’t continue to widen, fueled and fed by lack of access to clinical trials.”
This episode of The ShiftShapers Podcast is called “Finding The Right Stop-Loss Partner” and today, host and Chief Transformation Strategist David Saltzman is joined by Mehb Khoja, President of Medical Risk Managers, Inc. to discuss the topic from the perspectives of both employers and MGU’s.
Mehb explains the lag times experienced between incurring and paying claims, shares his insights on why it is not advisable to swing back and forth from fully-insured to self-insured, and defines what lasering is and its significance in this industry.
What You’ll Learn From this Episode:
01:56 Mehb’s position in the industry
08:41 Advisers chasing the lowest stop-loss cost
11:51 Lag times between incurring and paying claims
16:18 Advising clients and switching back to fully-insured
19:07 Lasering defined and predictions of growth
Quotes:
08:48 “I would, in any situation like this, advocate for a long-term partnership whether it’s with us or with another carrier, another MGU, simply because stop-loss claims are going to be volatile by nature and you’re looking to the stop-loss carrier or the MGU to help you with some volatility protection. And sometimes, the stop-loss carrier’s going to win, and sometimes the employer is going to win. And all in all, you want to make sure that you’re purchasing coverage at the right level and that you’re building a long-term partnership as you would with any other benefit carrier.”
12:03 “There’s really no downside in that very first year of self-insurance. The downside is in the subsequent year if you still have the same type of contract. So, for example, if ten employers select 12-12 coverage in the first year, and renews with a 12-12 coverage in the second year, there is a significant gap in coverage and that gap comes from claims that are incurred in the first year of self-funding but paid in the subsequent year.”
14:03 “When you’re thinking about large claims though, these are more complicated situations. This is somebody having gone to a surgical center or a hospital to have a catastrophic condition evaluated treatment on… so let’s take, for example, a transplant. And so, in that situation, the transplant claim, because of the size of the claim, it may go through various levels of scrutiny and review before the employer or the administrator is ultimately billed for the charges. And so, because of that, it is common to see lag time on larger claims be somewhere between 4 to 12 months.”
17:56 “Absolutely. I would say though, more importantly is, an employer shouldn’t be going back and forth between self-insured and fully-insured. I think if you’re of an appropriate size and you’re thinking about moving towards this direction of self-insured, you’re really going to evaluate the philosophical decision to go that way. And once you’ve made that decision that you want to be self-insured, you really don’t want to be hopping back and forth, back to fully-insured carriers.”
19:25 “Lasering is the ability for the stop-loss carrier to identify known claimants, known exposures, and to either exclude them from coverage or include them at a higher rate. And so, what does that mean? Let’s say the employer wants to select coverage at $100,000 per person per year. And during the medical underwriting and clinical underwriting process, it’s discovered that there’s an individual who is going to need a transplant next year. From the carrier’s perspective, that’s a claimant that’s already known and from their perspective, insurance coverage is to protect from the unknown.”
21:54 “I think the stop-loss industry is going to grow. It has been growing significantly. The current market is about $25 billion. And that’s up from about 10 to 12 billion just 6 years ago. And really, the driver of that has been the ACA and now what we’re starting to see is a lot of interest in self-funding from smaller employers who were previously fully-insured and those employers are going to need stop-loss coverage. So we’re going to see some organic growth coming from that market.”
This episode of The ShiftShapers Podcast is called “Finding Happiness When Success Isn’t Enough” and today, host and Chief Transformation Strategist David Saltzman is joined by Freda Doxey, Founder of the A Wise Coaching and Counseling Company. Freda begins by sharing some of her tools and techniques to deal with the stresses of 2020.
She goes on to explain the differences between internal and external stress and breaks down the 3 parts of internal stress: What am I thinking? What are the emotions attached to it? And what do I believe?
And to round up the episode, Freda explains the need for a coach and its particular differences with a mentor and a sponsor. She also answers the crucial question of how to find life’s happiness when success is not enough and the roles of helpfulness, satisfaction, and mindfulness in this equation.
What You’ll Learn From this Episode:
03:46 Stress in sales: Differentiating internal and external stress
08:20 3 parts of internal stress
12:50 Boundaries and saying no in sales
15:49 Knowing your focus and delegating
18:45 Finding happiness when success is not enough
Quotes:
04:07 “So with stress, it can be internal or external. And in sales, because I did sales as well with Dale Carnegie, it can be internal where you put the pressure on yourself. And it is that stress sometimes that is not managed well that creates a place where we do not perform well, and our people who we try to sell to can pick up on any internal stress.”
04:35 “Now, external stress, we will always have. Whether it’s from family or from the manager or from the company, you can always have external stress because the business model is simply, do more, faster, with less resources. So you’ll have the external. Once we learn how to manage the internal stress, then we can easily manage the external stress. But most of the times, we do not differentiate between the external and the internal.”
08:20 “And here’s the thing, there’s three parts to the internal stress, alright? So the first part for everyone who’s listening is, what am I thinking? You’ve got to analyze. How am I thinking and what am I thinking? Not so much why, but how and what. Second thing is, what are some of the emotions that attach to that particular thought that I am having? And here’s the core: what do I believe?”
12:50 “When I line up my schedule, when I decide where I’m going to go, what I’m going to do, I’ve got to be able to say no that this is not going to be most effective for me. And the more comfortable we get, we’re seeing how ‘no’ actually free us up to the yesses and life.”
18:56 “The insatiable desire. And that simply means along the same lines, you’re just talking about, will I ever be satisfied? And here’s the key that I taught to be satisfied: number 1, it’s not in things and stuff. Success is not measured by the things that we have. And here are some of the things: status. Status can be educational. It could be the number 1 top salesperson. It’s not measured in that.”
In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman is joined by Jim Hoitt, Senior Vice President at Captive Division at Berkeley Accident & Health.
Jim shares his in-depth knowledge and insights into the world of Captives and discusses its 2 models and the nature of each. He also takes a deep dive into the kinds of companies that benefit the most from a Captive, from their shared goals to the ideal company size to their financial commitments.
But Jim also discusses the major plus sides to the arrangement which include providing the best healthcare for companies at a lower cost, absorbing losses and mitigating risk factors to help ensure success across models. He also explains the key role an adviser plays in all of this and how the ultimate goal is to provide guidance and filter the best-fit companies.
What You’ll Learn From this Episode:
03:35 Explaining the 3 layers: Retained, shared & risk transfer layers
06:34 The heterogeneous vs homogenous models
10:25 Company profile: Who benefits the most from Captives?
15:27 Starting a Captive arrangement
18:24 The adviser’s role in starting a captive
Quotes:
02:14 “A Captive health arrangement is a financial arrangement for which an employer that decides to self-fund their health plan, buys medical stop-loss to back stop the assets of the health plan and then forms or joins a captive and the captive acts as a reinsurer to that medical stop-loss. Ultimately, what it creates is a kind of called financial envelope that wraps around the health plan and collaborates and shares with a number of employers to give them a mitigation to the concept of self-funding.”
02:49 “A Captive is a financial mechanism where a non-risk taking entity, an entity that doesn’t typically take risk, can participate and share in risk as if they were an insurance company. And when we talk about benefits captives, we talk about the ability to use medical stop-loss to participate in a Captive and provide a number of different financial values for the health plan.”
07:56 “They (heterogeneous model) don’t necessarily need to be like-minded in the benefit offering, in the co-pays, in plan designs, in the third party administrators and the PBM that supports the plan, but they should certainly like-minded and consistently focused with the other members on the results they’re seeking and the willingness to collaborate and have better results and ultimately provide great care but manage the cost across the health plan.”
08:34 “On the homogenous model, there is certainly an immediate affinity amongst the members. It’s our direct opposite. We’ve got a number of employers that are in a same industry for potential purposes. We’d also say there’s some homogenous to when we have a number of employers that are in one particular regional area and they share a community in terms of a greater community in terms of employment and a town and a particular part of a state, for example purposes.”
17:32 “I’d say those two elements, being focused on self-funding, having a clear risk management vision, and then then the third element, I would say, would be that they need to kind of be all in. They need to have somebody at their agency, whether it’s themselves or a part of their team that is really the quarterback on this because it’s certainly not the easy button. The easy button is still fully-insured.”
20:15 “If we do think of the Captive as essentially a bank account that allows funds to come in across a spectrum of employers, allows losses to seed in across those same spectrum of employers and allows those employers to then participate in the remaining premium balance. Or the opposite side of it. If there was some additional needed funding for it, they share in that risk together. That’s the mitigation that helps their health plan.”
22:50 “I think the first step is to consider what it is about that particular employer that makes them a good fit for it so when we kind of sort out the employer type is, do they have a willingness to treat their health plan as if it were another portion of their business, to treat it as if it’s something that really… that they can impact and want to be involved with? So I think it’s making sure that the employer is the right characteristics for the program.”
In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman sits down with Jeremiah Solven, Founder of the Conquer Academy.
Today he shares his unique mindset which he honed when he was in his Ranger unit, the Badmuthers, and explains how a triangle of leadership, personal performance, and character are at the core of this mindset.
With this mindset, Jeremiah pursues his best version of himself and this is what he teaches to his students as well.
What You’ll Learn From this Episode:
02:53 Jeremiah’s triangle: Leadership, personal performance & character
06:10 A Badmuther mindset
08:44 Tragedy and wrestling with feelings of failure
13:26 Growth by taking the harder path
16:18 Being a force of good & a culture of leadership
Quotes:
03:27 “I draw this out like a triangle. If you have the left side of the triangle is your leadership, the right side of the triangle is your personal performance, and then the bottom of the triangle is your skills and your character. What you’re trying to do in life is you’re trying to get to the top.”
06:57 “And one of the things we decided to do is, we said hey, we can’t control the outcome but what we can control is the process and the culture. And our identity as a platoon, I just said we were named after, our name was the Badmuthers. So we, as a culture, we embodied that and what a Badmuther meant was violence of action, professionalism, and grit. These are like the tenets of our culture.”
11:38 “And that was my last Ranger mission so I had to figure out what to do with that information. And I realized that night, years after wrestling with that night, that the common theme with everybody was that they embodied a Badmuther mindset. They didn’t stop moving forward. And so I felt like we lost. We actually won.”
15:10 “So how do you develop a Badmuther mindset? It’s by always choosing the harder path. So every time you get to a crossroads in life, you have an uphill option and a down. If you pick the uphill every single time, life gets easier. But the problem is that, for some reason as humans, we gravitate towards the easy path.”
18:07 “And so I couple all that into my coaching program. And I said, you know what I’m going to teach these things and my goal is just to bring more good in the world because it’s a simple goal. It’s simple but it’s not easy. And so I can tackle that for the rest of my life, chase it for the rest of my life and it’s almost like chasing perfection. It almost never happened, but the pursuit of it is intoxicating.”
In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman chats with Brian Clark to discuss the company’s perspective on Life settlements.
Brian is the Director of Business Development at Reliant Life Shares and he shares details on how companies handle life settlements, from paying out death benefits to undertaking risk to dealing with government regulation.
Brian also shares how individual investors can participate in this market and changing the mindset around life settlements to see the real value it has to those who need it.
What You’ll Learn From this Episode:
02:11 Life settlements: a life insurance company’s perspective
04:52 What investors get
07:34 Insurance company views and risks involved
10:49 Regulation
13:59 For investors: How to access the market
18:36 Common objections: Finding the value of life settlements
Quotes:
03:21 “Now once it’s sold, the investor group is waiting for the death benefit payout and, in our case, we open up investment on fractional basis to investors, individual investors, because historically the buyers of this have been big players like the Warren Buffetts of the world, Blackstone, national pension funds, big banks, etc but what we do is help individual investors participate in this asset class.”
04:08 “And that’s the true diversification that I think an exposure to life settlement investing can bring to investors when they’ve already got stock risk, they’ve already got real estate risk. And in this low-interest-rate environment we find ourselves in, especially now, what choice do you have?”
08:01 “So, in general, my experience has been they don’t love it. However, I think insurance companies certainly can be seen and don’t want to be seen as telling a senior that they can’t access value in a policy above and beyond what the cash render value is because that would end up hurting that senior.”
08:40 “A lot of times, these are illiquid investments so liquidity should be obviously your primary concern when you consider any investment. The time horizon involved, a lot of times we operate with life expectancy estimates between 3 and 8 years, typically not shorter than 2 and not longer than 8 but a person with an 8-year life expectancy certainly could live twice that long or longer and so longevity risk really becomes a primary risk to the investment.”
16:36 “I’m not going to say that a healthy person cannot sell their policy but the younger the person is and the healthier a person is, typically the less they’ll command for being able to sell their policy because, let’s just use 2 extreme examples, if you were going to buy the life insurance policy off of a 24-year-old Olympian who’s in great health and great shape, I mean how long is that person going to live, right?”
17:06 “On the other end of the spectrum, if we somehow knew I had 5 minutes to live and I have a life insurance policy, obviously you might be willing to pay more for that approaching the death benefit value.”
In this episode of the ShiftShapers Podcast, host and Chief Transformation Strategist David Saltzman chats with David Vivero, Co-Founder and CEO of Amino.
David shares his knowledge of consumerism in healthcare and discusses how consumers want transparency of information and choice, but not too much that it ends up frustrating them. He also talks about how Amino connects consumers to services they want and the engagement and ROI that employers can expect from offering this service.
What You’ll Learn From this Episode:
02:23 Complex healthcare for consumers
04:29 Getting the data
10:03 Building the knowledge for the interface
13:29 Directional vs absolute data
15:05 Services that consumers require
17:57 For employers: Engagement and ROI
Quotes:
03:29 “There’s a certain amount of complexity that we’re all willing to tolerate in our lives. And usually, we kind of reserve that for whatever our profession is and it just wasn’t enough for us to change the incentives in healthcare. We also had to change the interface to healthcare and that, unfortunately, took way too long for people to realize.”
03:59 “And frankly, a lot of observations from researchers and public policy people about how transparency frankly doesn’t work on its own in its first iterations so I think that we just didn’t really understand the nature of the new challenges that would be created once you rewrote the rules.”
07:57 “In order to do that, you need to have data that follows people over time that’s rich enough about those people to be able to isolate the sick patients from the not so sick patients and try to measure apples to apples across providers what they’ll do.”
14:25 “You can’t separate from the action you’re wanting a consumer to take which is we just want them to choose the higher value provider. We just want them to be aware of that difference and confidently step forward choosing a doctor or hospital or surgeon that is going to meet their needs without taking undue risk and without getting overly paid in a way that’s expensive to all of us paying that insurance premium.”
18:20 “We try to engage in a couple of ways which I think are quite highly differentiated. One is, we have built a product that was trained on tens of millions of consumers. And the interface, the experience. But we’re close on communication, the language that we’ve chosen, the value proposition, all of these are a package that is far more enticing than what has historically been presented to consumers as navigation, transparency, and a number of other things.”
