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.

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

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.

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