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

Pharmacy costs are increasing exponentially – some estimate that they will soon represent more than a quarter of all plan spend. Yet this portion of the industry is so opaque that it is nearly impossible to accurately understand what, exactly, is being paid – and where those payments actually go. Our guest on this episode is Kent Thomas, founder of Pharmatrix, a marketing firm focused on creating a fiduciary-like environment where PBMs become fully transparent.

What You’ll Learn From this Episode:

  • Defining terms such as spread pricing, AWP, rebates, etc.
  • The challenges advisors face speaking with prospects and clients
  • Who controls the market today, and why that matters
  • Beyond prescribing – the importance of clinical expertise
  • How a “fiduciary-like” model works for everyone

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small

ShiftShapersCoverArt

Drug costs are soaring and driving more of medical spend than ever before. The good news is that there are tools coming to market to help consumers and plans alike.

That is what our guest, Gary Becker, CEO of ScriptSourcing and I discuss on this episode. We begin with an exploration of why prescription drugs are so much more expensive in the United States than they are in other countries. We discuss the particular drugs that are driving the pharma cost component to all time highs.

Gary explains the three strategies being employed by many plans and discusses how advisors can have this conversation with their clients. We conclude our conversation with Gary’s view that advisors must start charging for their services on a quantifiable, performance-based structure.

What You’ll Learn From this Episode:

  • Why drugs are so expensive in the USA.
  • How pharma is driving medical spend consistently higher.
  • The expected increases in pharma costs in the coming years.
  • What constitutes international pharmacy management.
  • How specialty meds fit into the pharmacy market.
  • The landscape of international pharmacy tourism and its effects on the pharma market in the US.
  • Whether advisors should bring this model to their employers, and whether they should get compensated on a percentage-of-savings basis.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small

 

 

ShiftShapersCoverArtCommunication is a critical component of personal and corporate success. We may think of conversation and communication as an art, but it turns out that the keys to effective communication are firmly rooted in science.

On this episode of ShiftShapers we explore those connections with Rachael Bosch, Managing Director of Fringe Professional Development, a Washington D.C. firm that helps organizations, teams, and individuals reach their professional learning goals.

We spend the majority of our time in school on the core business skills needed to do our job. However, the soft skills – or professional skills – that help you develop and lead teams don’t receive as much attention.

When communicating with your team it’s important to think not only about the message you need to convey but also how that message will be received. Rachael provides helpful clues into how we can communicate more effectively based on research by top neuroscientists.

From Baby Boomers to Millennials, each birth cohort approaches career aspirations in a unique manner. Learning how to communicate generously and build community will positively impact an environment where the organization’s employees can remain engaged.

What You’ll Learn From this Episode:

  • Why professional skills are just as important as the core business skills.
  • The component of professional skills has the most room for improvement.
  • How different generations learn and approach professional skills in the workplace.
  • Why it is important to learn how Millennials use their drive and professional skills.
  • Four filters that can boost effective communication results.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-small

ShiftShapersCoverArt

This week, we continue our conversation with a pioneer and disruptor in direct primary care (DPC): Samir Qamar, M.D. Dr. Qamar is the founder and CEO of  MedLion and MedWand. On this episode of Shiftshapers, Dr. Qamar shares his latest invention, which aims to take telemedicine to another level.

Telemedicine is a huge component of the direct primary care model. First generation telemedicine tools only allowed doctors to provide consultations because doctors weren’t able to examine patients. MedWand is a project that Dr. Qamar is working on that would launch telemedicine into the future. MedWand makes health care portable and interactive.

We talk about a brand new device that Dr. Qamar is bringing to market – a mouse-sized piece of technology that has the potential to revolutionize patients’ interactions with their physicians. This new technology will allow physicians to spend more appropriate time with clients. Tune into this insightful exploration of the new technologies being developed that will help extend our virtual interaction with our primary care providers.

What You’ll Learn From this Episode:

  • Whether direct pay will take primary care/family medicine back to the era of the family doctor.
  • The evolution of today’s telemedicine.
  • Why the first generation of telemedicine wasn’t helpful for more than consultations.
  • How accessible this technology is for consumers.
  • Why frequent claims are an insurance killer.
  • The other technology coming to market that will extend our electronic interaction with providers.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-small

ShiftShapersCoverArt

On this episode, we’re honored to be speaking to a pioneer and disruptor in direct primary care (DPC): Samir Qamar, M.D. Dr. Qamar is the founder and CEO of two companies, MedLion and MedWand. DPC revisits a traditional business model that eliminates insurance for non-catastrophic health care needs.

In this first episode of our two-part interview, we asked Dr. Qamar to talk about the ins and outs of the direct primary care model and share his unique journey into that field. We also talk about how the direct primary care pioneers were able to get the DPC inserted into the ACA, and how DPC realigns incentives. We’ll explore how DPC might be a good fit for clients struggling with today’s increased personal responsibility amounts, and how they coordinate with and complement high deductible plans.

DPC offers an exciting alternative as insurance rates and health care costs continue to skyrocket. Dr. Qamar shares how health care costs can be dramatically reduced by taking a fresh look at how we price primary care services. The quality of care and access improves with this new approach. Benefit advisors will learn how to best position this service to assist their clients.

What You’ll Learn From this Episode:

  • What a direct primary care is and how it differs from fee-for-service.
  • How Dr. Qamar developed a direct primary care practice catering to the general public.
  • How a key change in PPACA made a big difference.
  • Whether DPC is an individual play, a group play, or both.
  • Why insurance is unnecessary in primary care.
  • Strategies that benefit advisors should know to help clients avoid penalties and adverse experiences with DPC.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-small

ShiftShapersCoverArtAfter a market contraction due to a low interest rate environment and its effects on reserves as well as challenges understanding the pricing on a relatively new product, Long Term Care is poised for a comeback.

In part two of two, Bill Dyess and I continue our conversation about the future of Long Term Care insurance. Bill is the President of Dyess Insurance Services and one of the country’s foremost experts on long-term care.

Bill and I talk about how hybrid policies, which combine life insurance or annuities with Long Term Care insurance, have added a new wrinkle to the insurance marketplace. We measure some of the pros and cons of hybrid plans and highlight the importance of the advisor’s role as consumer educator.

The caregiver side of the equation is also important to weigh in the discussion of Long Term Care insurance. LTC can be a useful tool for caregivers, who must care for their own lives as well as those of their loved ones. As the nature of caregiving changes – trending younger and toward parity in caregivers’ gender – it is even more likely that LTC insurance will become more popular.

What You’ll Learn From this Episode:

  • The likelihood of an illness or accident triggering a Long Term Care claim.
  • How hybrid policies and plans are designed, and how they may affect the resurgence of LTC.
  • The role of partnership plans in protecting the consumer’s assets in the marketplace.
  • The changing nature of caregivers, and why LTC insurance is a tool they can utilize to ensure their loved ones get the care they need.
  • How to get into the Long Term Care space as an advisor.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-small

ShiftShapersCoverArtAfter a market contraction due to a low interest rate environment and its effects on reserves as well as challenges understanding the pricing on a relatively new product, Long Term Care is poised for a comeback.

On this first of a two-part series on the ShiftShapers Podcast, we’ll investigate a resurging need for long-term care insurance. There is a 75% chance that those who reach the age of 65 will need long-term care at some point in their lives. Our guest, Bill Dyess, is President of Dyess Insurance Services. He is one of the country’s foremost experts on long-term care.

Getting hurt or becoming sick and needing long-term care as a result of a chronic condition can happen at any age. While long-term care is primarily associated with the needs of an aging population, though anyone at any age can face this challenge. Bill will help explain the differences and the need for disability vs. long-term insurance.

In the 1980s and 1990s, there was an explosion of long-term care products. As the costs associated with long-term care exploded, the availability of products disappeared. The population is aging and surviving previously fatal diseases at a higher rate which makes an interest in long-term care insurance a new opportunity. There is a resurgence in the number of carriers in the marketplace and today we discuss what this means for advisors.

What You’ll Learn From this Episode:

  • A history of the long-term care product and why there is a resurgence of product offerings in the marketplace.
  • Typical costs associated with various categories of long-term care assistance.
  • Strategies for minimizing the costs of premiums and what effect that has on out of pocket expenses.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-small

ShiftShapersCoverArtAccording to the CDC, over 29 million people in the US are diabetic. It costs more than $176 billion to treat diabetes – so how can employers and employees manage the treatment and complications of this lifelong disease?

Today Tom Milam of TrueLifeCare talks about just how big the diabetes problem has become in the workforce. He distinguishes between the two components contributing to the scope of the problem, which is affecting employees across age cohorts: costs associated with diagnosing and maintaining diabetes, and those associated with its complications. Tom also shares some staggering figures about how much employers pay for employees with diabetes compared to those without.

We then cover how advisors can find data about their clients’ employees to understand how diabetes is affecting their workforce. Tom talks about some of the tools advisors are using to discuss diabetes management with employers and strategies to minimize the disease’s costs. He also shares some research from the Northeast Business Group on Health describing why previous attempts to curb diabetes costs in employees haven’t been successful, and how to change tactics going forward.

Tom shares how much of a struggle it can be to keep employees engaged with the daily choices they must make to keep diabetes in check. While there is no single solution, incentives and other tools can help employers keep their employees healthy and save money for them both.

What You’ll Learn From this Episode:

  • How large the problem of diabetes has become in employee populations.
  • Why it’s important to consider complications of diabetes when calculating healthcare costs, not merely diagnosis and maintenance.
  • How much diabetes currently costs employers and employees, compared to average employee costs.
  • How advisors should discuss these challenges and potential solutions with prospects and clients.
  • Why it can be tricky to get employees engaged in counteracting diabetes.
  • The shift from tell-oriented to help-oriented disease management programs and their effect on employees with diabetes.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-small

ShiftShapersCoverArt

At the recent NAHU Convention, we spoke with Lillian Shapiro, president of HR360, about some of the challenges that benefits advisors face from companies providing “free” stuff in exchange for Agent of Record Letters. She points out that this type of marketing is not a new hurdle, but one that has reappeared at a particularly interesting time in our business.

On this episode of ShiftShapers,Lillian shares a simple yet powerful technique brokers can employ to give them a competitive advantage over any technology platform. She offers advice and ideas to help advisors become more effective and efficient in closing new clients and retaining existing ones. Lillian believes that advisors today have a unique value proposition – they simply need to learn how to present it in a compelling and competitive manner.

What You’ll Learn From This Episode:

  • The challenges advisors have faced in the past with freebies.
  • How to ensure your clients know the full scope of the services you provide.
  • How to use checklists and newsletters.
  • Why social proof matters.
  • The secret weapon in every client relationship.

Featured On The Show:

Listen To The Full Interview:

Enjoy The Show?

Subscribe-with-iTunes-small Subscribe-with-Stitcher-small

ShiftShapersCoverArt

It often seems as though the world of employee benefits is exempt from many of the forces that impact other industries. Kara Trott, Founder & CEO of Quantum Health, knows that is not true, and that much of what happen in other industries – especially retail sales – can help us to improve our industry and the client experience we provide.

We invited Kara to share her experience with using strategies from retail store design and product intercept to help lower healthcare costs and improve experience. She also talks about how these strategies apply to managed care companies, insurance companies, and patients. Kara believes that today’s consumers often feel like Dorothy, dropped into the land of Oz: confused, disoriented by a consumer experience unlike any other and with a multitude of simultaneous decisions for which they are unprepared.

She shares the lessons she has learned and techniques you can master to make those clients feel like they are back in Kansas again.

What You’ll Learn From This Episode:

  • Her journey from retail and commercial enterprise to the health industry.
  • Strategies and lessons learned from Citibank, Ford, Walmart and Kmart.
  • Where disconnects happen.
  • Why today’s consumers feel like Dorothy, dropped into Oz.
  • The widely-held theory that the physician is at the center of the trust relationship.

Featured On The Show:

Listen To The Full Interview:

Enjoy The Show?

Subscribe-with-iTunes-small Subscribe-with-Stitcher-small