This week’s episode features a conversation with Deb Rubin, Certified Life and Success Coach at Deb Rubin Coaching. Oftentimes successful people base their success on the standards of others while disregarding their own personal happiness and values. Deb teaches her clients how to recognize their limiting beliefs and introduces S.M.A.R.T. goals which stand for Specific, Measurable, Achievable, Relevant, and Time and how this can bring real joy into lives that have become lost in life’s treadmill.

What You’ll Learn From This Episode:

• 02:00 What version of success are you working on?
• 05:48 Defining limiting beliefs and its effect on you
• 10:15 Visualization and overcoming limiting beliefs
• 15:36 S.M.A.R.T. goals: A strategy to achieve what you truly want
• 19:27 Using a to-do list effectively

Quotes:

05:39 “Our minds are brilliant, brilliant creations but they’re also the source of a lot of struggle and personal pain.”

09:02 “The mind does things like that to us. So a limiting belief, for example, is one way our minds actually hold us back from achieving what we want most in life.”

14:55 “They’re chasing this goal that doesn’t really align with who they are and what matters to them. And once they bring that into alignment, they take the time to bring it into alignment, life becomes fun again.”

15:57 “S.M.A.R.T. Goals is a process to allow you to achieve your goal. Any goal that you have that you can’t utilize the S.M.A.R.T. process for is a goal that most likely you won’t achieve.”

21:20 “When you put something on your list, you want to determine how important it is. Is it a real goal? Can you create a S.M.A.R.T. element around it? Are you passionate about it? Will it make a difference in your life?”

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This week’s episode features a conversation with Craig Clemente, President & Chief Operating Officer at Specialty Care Management. Specialty care is both a claims exposure and a clinical component and Craig details how plans need to focus on both. He also explains the nuances of the plan document language and the need to have member champions to spread awareness. Finally, Craig discusses the steps plans can take to bring down the extreme costs of specialty drugs and air ambulances.

What You’ll Learn From This Episode:

• 01:45 Specialty care defined: When do they get involved?
• 06:36 Explaining the language of the plan document
• 08:19 Involving patient members and educating about specialty care
• 14:34 Managing the costs of specialty drugs and air ambulances
• 18:42 The future of specialty care

Quotes:

06:54 “It is really important that we look at this not as a diagnosis in that you cannot be discriminatory in any way in your plan document, whether that’s for again dialysis or anything else.”

13:28 “Ultimately, I think one other key component is you always try to find that individual within the member population that’s going to be your kind of vocal champion, your internal supporter.”

16:48 “Average cost of an air ambulance ride is about $49,000 and many times, it’s much much higher than that. And there’s no real regulation in this space.”

18:24 “We’re seeing that we’re upwards of 70 to 80 percent off total bill charges in those scenarios even with companies that have never traditionally given anything over and above 30 percent historically.”

19:12 “The overarching theme here is risk management and understanding that risk management works well beyond a single BUCA entity, for example, where you’re just putting one solution in place to manage everything.”

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This week’s episode features a conversation with Robert LeCureaux, Vice President of Client Development at ScoutRx Pharmacy Benefits Consultants. PBMs have been focused on profitability rather than providing a beneficial service. Though alternative funding options are available, PBMs are less likely to cooperate since there is no financial incentive to do so. Robert’s group helps members minimize their spend by offering Specialty Pharmacy, Copay, and International Pharmacy Programs.

What You’ll Learn From This Episode:

• 01:55 PBMs have been focused on profitability
• 05:29 Specialty drugs: The rising cost and alternative funding options
• 13:30 Mitigating costs for partially funded employers
• 15:50 Specialty meds compliance
• 18:46 Using a hands-on approach to educate employees

Quotes:

04:29 “Drug manufacturers are increasingly raising the cost of these medications so while getting a great discount may curb your spend a little bit or keep you from bleeding too much, it’s really effectively doing nothing to lower or maintain your spend.”

05:40 “The driving factor that we’re looking at typically is specialty medications. They used to be a little more rare, a little more infrequent, however manufacturers have gotten wise to the fact that there are no alternatives. They own the patents.”

07:22 “Patient assistance programs, these are a little less publicly advertised but these are foundation programs to cover medications at a hundred percent of the cost for your specialty meds.”

15:26 “One solution really isn’t going to fit all groups. You really need to have a full suite of options that play off of each other to give that one kind of targeted solution to really maximize what you can do with the spend.”

19:56 “To make these programs effectively run, at least with us, we are very engaged with the members. With our international component, we proactively reach out to the members, educate them on the program.”

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This week’s episode features a conversation with Dr. Diane Hamilton, Founder and CEO of Tonerra , and author of “Cracking the Curiosity Code”. Curiosity in the workplace enables out of the box thinking and strengthens emotional intelligence through empathy, a key competency to talk to clients on an emotional level. Creating a culture of curiosity starts with the leaders who need to recognize the potential savings and revenues that curiosity can create when it translates to innovative business ideas.

What You’ll Learn From This Episode:

• 03:04 Curiosity is like baking a cake
• 07:41 Empathy: The link between curiosity and emotional intelligence
• 13:32 Building a culture of curiosity in organizations
• 18:04 For leaders: Curiosity offers massive potential savings and revenues

Quotes:

04:40 “The word is curiosity, which is very broad and can mean a lot of things to a lot of people, but to me what it is in the work setting is getting out of status quo ways of doing things.”

06:19 “If you look at the data from curiosity and for creativity, it’s about from age five where it starts to tank and by the time you’re out of high school age, it’s very very low.”

09:09 “Empathy is all about putting yourself in somebody else’s shoes and that really is so critical and to do that you have to ask questions.”

14:09 “We know that people aren’t communicating well. We know that they’re showing up to work without a sense of engagement. We know the emotional intelligence issues. So first of all, a leader has to recognize the financial aspect because I think that’ll hit home.”

21:53 “All these leaders for them to really get it with curiosity, they have to recognize the cost that they’re losing for not being curious, the potential that that would bring in terms of revenue by being curious.”

Resources:

Daniel Goleman: https://drdianehamilton.com/building-emotional-intelligence-through-mindfulness-meditation-with-daniel-goleman/

Francesca Gino: https://drdianehamilton.com/the-force-of-curiosity-with-francesca-gino-and-the-perception-of-happiness-with-silvia-garcia/

Doug Conant: https://drdianehamilton.com/creating-powerful-leadership-connections-in-the-smallest-moments-with-doug-conant/

Amy Edmondson: https://drdianehamilton.com/teaming-versus-teams-with-amy-edmondson-and-body-language-secrets-revealed-with-greg-williams/

Curiosity Code Index: https://drdianehamilton.com/curiosity-code-system/curiosity-code-index/

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This week’s episode features a conversation with Scott Campbell, Senior Vice President of Stealth Partner Group. Advisors need to be aware of new trends that are beginning to help shape an updated stop loss segment. The shift to direct contracting and broader data sets help employers make smarter choices in their self-funded plans so they gain control, provide a better employee experience and enjoy continued and growing cost savings.

What You’ll Learn From This Episode:

• 06:20 Self-funding produces data for better cost savings
• 10:14 Managing cost drivers and direct contracting as a growing trend
• 14:51 Improving health plans and controlling facility charges
• 17:33 Effects of stop loss innovations on consumers

Quotes:

05:43 “Manage your health plan like you manage the rest of your business. That’s what I think is a big disconnect in the insurance world.”

08:17 “There’s no way to control your cost staying fully insured. The only way to really ever take control of your health ben is be self-funded.”

11:48 “I think the trend is going to be the direct contracting in their own networks. I think that allows you to get better unit price cost, allows you to dictate care better than what a BUCA can do.”

16:20 “What are we trying to do for the member, which the DPC and those kind of physician things are important, and then what are we doing for the plan? And that’s when you need to attack the unit cost at the facilities.”

18:19 “It just seems like healthcare is one of these things where you don’t want to tell people what to do but it’s just getting to the point now where it’s just so unaffordable.”

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This week’s episode features a conversation with Charles Henson, Managing Partner of Nashville Computer. Working from home can be a perilous electronic journey, especially for those of us without technical teams available. Charles and David discuss the prevalence of cybercrime and what you and your family can do to create a more secure computing environment and how to keep your information off the dark web.

What You’ll Learn From This Episode:

• 06:20 Password hygiene: Why you need to do it
• 08:19 Managing passwords: LastPass and 1Password
• 14:56 For parents: Learn about location services and the dark web
• 20:49 Special offer by Nashville Computer for ShiftShapers listeners

Quotes:

04:02 “All of these are devices that can be penetrated and accessed remotely if they are not secure.”

07:25 “If that password is compromised, you have to go change it in one place and the hacker can only get into it at that one place not everywhere that you’re using it.”

13:37 “That camera, if it was just plugged up and they left the username and password as a default, then they were online on that website.”

16:54 “If I were stalking someone, I could totally use that app to stalk somebody, to see exactly where their location is, and see where they live on the map.”

19:16 “It is an anonymous marketplace but for today, you can go there and you can buy drugs. You can have them mailed to your house. You can buy social security cards. You can buy stolen credit cards.”

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This week’s episode is a conversation with Steve Peterson, Partner at Tress Solutions. Today, Steve shares his professional journey which is defined by recognizing good opportunities and taking the plunge.

He tells the story of how he adapted to his client’s needs and provided solutions to their biggest pain point: cannabis trash collecting. Steve explains that investing in the right people came first in entering an emerging cannabis niche worth $5 billion.

What You’ll Learn From This Episode:

• 07:21 Seeing new perspectives and challenging the status quo
• 12:13 Cannabis waste: Addressing urgent problems and finding opportunities
• 16:31 Investing in people first and products second
• 19:01 The cannabis industry: A great product with room to grow

Quotes:

06:46 “You might create something that’s good but not good enough. And I think you’re constantly forced to look and say well, how can we make this better?”

07:18 “The buyer didn’t want to have more compliance software. What they wanted was somebody just to frankly pick up their trash. So we have to adapt and say, okay, we’ll pick up your trash.”

11:50 “Until you can see it and feel it, you don’t really truly understand what problems they’re having. And so from that knowledge, then you can really architect the better solution.”

13:19 “We started seeing a whole alternate industry out there which is basically taking those stalks, stripping them down, and turning them into things like clothing, bedding, industrial hemp. So that whole market is a $5 billion market.”

18:10 “Let’s not play this game of my product is $5 cheaper. Let’s buy the waste from the grower and say we’ll take it from here so they don’t have to pay for it. It solves an economic problem for the customer, at the same token from an ecology standpoint.”

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This week’s episode is part 2 of our conversation with Sean Schantzen, Co-Founder and President at Health Rosetta Group. Today, Sean predicts what the future may hold for the insurance industry and the tools and techniques needed to meet those changes.

Sean discusses the trend of mid-market companies banding together to rebuild infrastructures and the increasingly commonplace occurrence of building their own hospitals. He also discusses the main factors that drive pharma costs and the changes that are reshaping views on risk management.

What You’ll Learn From This Episode:

• 01:58 New mid-market company solution: Building their own hospitals
• 07:20 Influencing politics and using advisors as coordinators
• 10:12 Pharma cost drivers: Supply issues, drug management, and pricing
• 15:25 Changes in risk-management and the re-localization of risk

Quotes:

02:34 “We can pull together the capital and we can pull together the lives and we are influential in our communities. We could track
the doctors. We could do everything. Why don’t we just build a hospital or buy one or take it over?”

02:54 “We’re so frustrated with the way things have been going for so long and it’s been such a fight that, forget it, we’re done.
We’re just going to start over.”

10:36 “The entire model by which we price and distribute and have supply chain for drugs we all know is flawed in many, many ways.”

11:54 “That’s a supply chain issue which is replace the existing supply chain or decapitalize so much through technology and through
very, very specific types of business models that are borrowing from the tech community.”

20:35 “When you have community owning the skin in the game, the people that are most impacted by going wrong and the people that can most manage and keep it going right, that opens up an entirely new world.”

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This week’s episode is a conversation with Sean Schantzen, Co-Founder and President at Health Rosetta Group. Today, Sean shares his insights on what top advisors are doing to bring innovation, control, cost savings, and better user experiences to their clients.

Sean explains that transparency is central to reestablishing a relationship of trust between advisors and employers. He also discusses the Mr. Potato Head problem and how architecting new plans from the ground up is the only solution to give stakeholders what they really want.

What You’ll Learn From This Episode:

• 02:18 Examining the role of advisors today
• 07:37 Advisors are experimenting to create higher-value offerings
• 09:56 Changing the compensation model with transparency and trust
• 14:54 Architecting new plans and solving the Mr. Potato Head problem
• 19:03 How firms and individual advisors can usher in changes

Quotes:

07:37 “These business models that are moving away from the traditional staffing plan as an advisor into new models that maybe are more member-centric. They may be more analytic-centric. They may be more contracting and legal-centric.”

08:27 “They’ve gained experience that’s necessary to understand how they then pull all these things together to create a much more highly differentiated and high-value offering.”

11:37 “Being transparent in compensation, top to bottom, if anything overly transparent, kind of sets the stake in the ground to reestablish a relationship on more trust.”

16:39 “They’re solving the Mr. Potato Head problem. This is contracting. It’s vendor selection issues. It’s cross-vendor collaboration. It’s how your underwriter’s going to give credits and react to this.”

20:34 “It’s less about the size of the firm that the advisor is at and more about the commitment of the advisor and their team to building what they want to build and the willingness of their clients to go along with them.”

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