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

This week, our subject matter expert Daniel Wells, Executive Vice President of Business Development for Endeavor Plus, joins us to discuss emerging trends in consumer-directed health care plans. We investigate what’s working well, what can work better, and the tools available that will help self-insured consumers make effective decisions about their health care options.

Join us as Daniel shares his takes on the overall state of consumer-directed health care plans. We also discuss why the network-driven, fully-insured marketplace is no longer sustainable. As an alternative, the outcome-based reimburse model may offer solutions that commercial insurance providers can leverage to increase medicare reimbursements and make more money.

Daniel explains how and why the recent election may force a pivot by insurance providers to an outcome-based reimbursement model. We wrap up the conversation by discussing his predictions on just how the initiatives in a President Trump administration will impact the way consumers approach their health care decisions.

It’s been said that when you engage consumers by their wallets, their hearts and minds will follow. Daniel’s expertise in driving health care related behaviors in a direction that saves money and improves the consumer experience will be a valuable insight for advisors.

 

What You’ll Learn From this Episode:

  • Whether CDHP Plans are working or not.
  • What the burden of consumer education will be if reference-based pricing becomes more widespread.
  • Trends on the horizon concerning networks.
  • Whether selling across state lines is actually a significant cost saver in the consumer marketplace and which groups most benefit from this concept.
  • Whether the network-driven fully insured marketplace is viable for groups.
  • Various ways HSAs might expand.

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

Steve Kelly is the President and Co-Founder of ELAP Services. He’s the foremost expert in a field that a lot of people are talking about – reference-based pricing.  As our guest on this episode of ShiftShapers, Steve will help us understand the ins and outs of reference-based pricing, why it’s important, and where it will take our industry in the future.

There is a resurgence of interest in self-insured plans as companies look for ways to keep healthcare costs down for employees. Advisors can help guide their clients through the type of support and advocacy position necessary to complete a transition with the practical tips discussed on this episode.

Advisors will want to closely examine a metric-based pricing model as they’ve been shown to provide significant, year-over-year savings. Stop-loss carriers are showing significant credits on their premiums at this point. The savings will undoubtedly help employers control the facility costs – the largest component of medical expenses. You’ll learn just how to take action on today’s episode.

What You’ll Learn From this Episode:

  • An explanation of metric-based pricing.
  • Where metric-based pricing applies.
  • What we can learn from the CalPERS example.
  • The unfortunate employer dilemma.
  • The source of most high dollar claims.
  • Whether there is applicability to pharma spend.

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The-Shift-Shapers-Podcast-(Rough-Comp-2)On this episode of ShiftShapers, we’re pleased to welcome Sally Poblete, the CEO of Wellthie, to discuss how consumer expectations are influencing technology trends in the health care industry. Since everyone from millennials to baby boomers is eagerly adopting tech tools and mobile devices to manage their daily affairs, it stands to reason that consumers would gravitate toward tools that simplify their health care decision-making process.

Sally shares why she believes the eCommerce movement in health care upon us. Benefit advisors who embrace technology can play an integral role helping their clients make the best decisions. She provides tips for advisors looking for obvious starting points to incorporate technology as they seek to connect with a broader audience.

A recent study found that only 14% of consumers are proficient regarding their ability to make health care decisions. Useful software tools are being developed. Savvy advisors will position themselves to help consumers bridge the knowledge gap. Sally shares what advisors should know and how they can adequately prepare to address that need.

What You’ll Learn From this Episode:

  • Sally’s background and how that lead to her current career.
  • An explanation of the retailization of health care markets.
  • How benefit advisors can encourage health care engagement vs avoidance.
  • The level of health care knowledge within the general population.
  • The transition away from spreadsheets as advisors embrace technology to better serve clients.
  • How millennial consumer behavior will impact health care decision-making trends.

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