The-Shift-Shapers-Podcast-(Rough-Comp-2)

Specialty drugs represent an ever-growing driver of our overall enormous drug spend. Pramod John, our guest on this episode, is CEO of Vivio Health, which is singularly focused on using outcomes revealed by data and analytics to bend the hockey-stick curve of this spending trend.

What You’ll Learn From this Episode:

  • Why do Americans have the highest drug costs?
  • Exploding the myth that Americans’ costs are highest because we pay for all of the R&D while the rest of the world benefits.
  • Can Amazon, Aetna/CVS, etc. solve this problem?
  • How can we be efficient and effective when there are five times more pharmacies than McDonald’s?
  • Are PBMs part of the solution or part of the problem?

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

There is a fast-growing movement toward bundled, all-in one-price medical services that save money, provides less complexity for members, and may make networks (as we know them today) obsolete. Our guest on this episode is Stan Schwartz, M.D., the Chief Medical Officer of The Zero Card, a company which is in the forefront of making this dramatic change.

What You’ll Learn From this Episode:

  • What is the scenario when rates are unbundled?
  • How rates get bundled.
  • Is this a region-by-region or a nationwide play?
  • How to gain employee engagement.
  • What advisors need to know to have an effective client conversation.

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Direct Primary Care (DPC) has been available for some time, but it has been marketed mainly to individuals. Today, a small number of DPC doctors and executives are making substantial strides toward breaking into the employer market. Our guest, Alex Lickerman, MD, Founder and CEO at ImagineMD, thinks the time is right and explains how it all works.

What You’ll Learn From this Episode:

  • Understanding the different DPC practice models.
  • The “single shingle” practice still plays a role.
  • What advisors need to have credible and successful C-Suite discussions.
  • How increased interest in partial self-funding is accelerating the opportunities.
  • Why working with advisors helps DPC practices adapt and prosper.

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Gene Thompson is both a Project Director and Director of Health City Cayman Islands (HCCI), an amazing facility that is delivering higher quality, lower cost care with greater patient satisfaction scores. Pioneered by Dr. Devi Shetti, a physician and health care visionary based in India, HCCI has become a leading model for medical tourism.

With the increased interest in self funding, the cost and quality curtain is being pulled back. Many U.S. companies are offering huge employee incentives in exchange for the quality and lower cost they provide. Gene offers a fascinating insight into this growing trend.

What You’ll Learn From this Episode:

  • How does the vision of how health care is delivered in the west drive HCCI?
  • Who is Dr. Shetti and why is his model driving change in hospital-based care?
  • What pricing methodologies are at work and what savings are there?
  • How is quality measured in these facilities?
  • What is the experience like for an employee who takes advantage of HCCI opportunities in their plan?

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Relatively new to the benefits arena, Dawn McFarland, President of M&M Benefit Solutions began to look around and realized that there weren’t many OTHER new folks coming into the business. Worse, many older practitioners are aging out of the business with no succession plans.

Coupled with her involvement with the California Association of Health Underwriters, she has started one of the few intern and mentorship programs in the business. Now, she wants to scale it.

What You’ll Learn From this Episode:

  • What the scope of the problem is.
  • Is there a natural influx of new practitioners equal to those leaving the business?
  • How to formalize a program.
  • Finding strategic partners is just like prospecting.
  • The success story so far.

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Travel for treatment used to be an esoteric benefit reserved for only the largest of employers. Today, the benefits are as much quality as cost driven and most often involve fully-accredited facilities. Some even use U.S. physicians and are attached to teaching hospitals. Yet for many employers and employees it still remains mysterious.

Jim Polsfut, CEO and Chairman of North American Specialty Hospital, helps us to understand the changes and how to help clients embrace a benefit that is advantageous to both employer and employee.

What You’ll Learn From this Episode:

  • What problems can travel for treatment overcome?
  • Why it has taken so long to catch on with average employers.
  • How quality now drives the decision.
  • New patient-centric features.
  • Should plans rewrite SPDs to require travel for treatment?

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Gene Thompson is both a Project Director and Director of Health City Cayman Islands (HCCI), an amazing facility that is delivering higher quality, lower cost care with greater patient satisfaction scores. Pioneered by Dr. Devi Shetti, a physician and health care visionary based in India, HCCI has become a leading model for medical tourism.

With the increased interest in self funding, the cost and quality curtain is being pulled back. Many U.S. companies are offering huge employee incentives in exchange for the quality and lower cost they provide. Gene offers a fascinating insight into this growing trend.

What You’ll Learn From this Episode:

  • How does the vision of how health care is delivered in the west drive HCCI?
  • Who is Dr. Shetti and why is his model driving change in hospital-based care?
  • What pricing methodologies are at work and what savings are there?
  • How is quality measured in these facilities?
  • What is the experience like for an employee who takes advantage of HCCI opportunities in their plan?

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Jack Hooper, Founder at Take Command Health, believes that data is the key to helping consumers connect with the plan that is right for them. Employees make plan decisions for a variety of reasons, but often do not find the plan that is right for them and do not understand the long-term impact of selecting the wrong plan.

We discuss why it has been impossible for consumers to shop for healthcare in much the same way they shop for most everything else in their lives and Jack highlights some solutions that are coming to market.

What You’ll Learn From this Episode:

  • What the right decision is and how consumers can find it
  • What pre-group options are and why they matter
  • The big opportunity for benefit advisors
  • How to have the benefits conversation with employers
  • What decision support tools are needed

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Talking politics and benefits is like walking a tightrope in heavy winds, but our guests say it can be done without falling off. Hear more of their advice in the second part of this two-part interview.

With healthcare so tied to politics these days, many advisors feel they have no way to avoid the subject when speaking with prospects and clients. Can you maximize your impact as an advisor and remain politically neutral? Jess Waltman and Dave Mordo say, “yes”.

In fact, they believe that if you do it the right way, that conversation helps to position you as an expert. They provide some real-life examples that show how having those discussions can provide a real business advantage. Jess and Dave caution that you have to know your audience and offer techniques (such as turning the conversation to compliance) to offer a safety net for those “other” parts of the conversation.

What You’ll Learn From this Episode:

  • What it means to know your audience—and why it’s so important.
  • Which modes of communication are the most effective.
  • Tips for calming a client who may be nervous about compliance.
  • How to stay on top of the information you need to remain a subject-matter expert for your clients.
  • Why the need for employee benefits specialists is stronger than ever.

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Talking politics and benefits is like walking a tightrope in heavy winds, but our guests say it can be done without falling off.

With healthcare so tied to politics these days, many advisors feel they have no way to avoid the subject when speaking with prospects and clients. Can you maximize your impact as an advisor and remain politically neutral? Jess Waltman and Dave Mordo say, “yes”.

In fact, they believe that if you do it the right way, that conversation helps to position you as an expert. They provide some real-life examples that show how having those discussions can provide a real business advantage. Jess and Dave caution that you have to know your audience and offer techniques (such as turning the conversation to compliance) to offer a safety net for those “other” parts of the conversation.

What You’ll Learn From this Episode:

  • Can you actually talk politics with your clients?
  • The importance of differentiating between politics and policy.
  • Why talking politics in the right way can demonstrate your expertise on the subject matter.
  • How to talk about political topics in the right way.
  • Different strategies to use when politics are involved.

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