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Within our own firm – and for clients – technology has become an often-confusing maze of choices. How do you know what to look for and how to make the right long-term choice? Jeff Severson, President of Trinity Advisors, has made a career of learning how to keep advisors and their clients from falling into tech traps.

What You’ll Learn From this Episode:

  • One size fits none.
  • User experience is key in today’s employment market.
  • Corporate culture as an important decision point.
  • Red flags to watch out for.
  • The benefit of a long-term focus.

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According to our guest, Erica Kiefer, VP of Sales and Marketing for AgencyBloc and a tech veteran in a number of sectors, we often neglect to investigate some critical questions when choosing software. In addition to looking at the user interface or the sheer functionality of any tool, Erica cues us in on the questions behind the questions that will ensure we end up with the right tools.

What You’ll Learn From this Episode:

  • Why tech we purchase often creates more confusion than it resolves.
  • Are demographic shifts changing advisors’ expectations and vendors’ offerings?
  • How can buyers get beyond the product when evaluating choices?
  • The critical importance of owner engagement.
  • How does your choice of tech inform your brand integrity?

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ShiftShapersCoverArtBuying leads has become more of a science than an art and the process is infused with new technology that helps you treat each lead like a $1000 bill.

We asked Richard Bufkin, President of Target Leads to update us on lead purchasing, a traditional process that has been brought very much up to date. Richard is the second generation of a business that is 32 years old and that has been in his family for 25 years, so he has seen that evolution up close and personal.

During our conversation, Richard also dispels some commonly held beliefs. For some products, fancy mailing pieces generally do not perform better than plain old black and white mailings. We learn how reply options have changed greatly – including “PURLS” (personalized URLs).

We learn about the critical importance of an integrated CRM and how your response time may dictate your success. Richard also talks about clustering, and resting zip codes.

What You’ll Learn from This Episode:

  • How Target Leads – a family business – has changed over time.
  • What’s new in lead purchasing.
  • Why CRM systems are critically important.
  • What “clustering” is and how it affects lead generation.
  • Why Richard will lock out leads for 90 days.
  • Which is more effective – fancy color mailings or plain old black and white.
  • What PURLs are, and why they’re so crucial to getting exposure.

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Deb Ault and some of her fellow RNs were against managed care when they were working at patients’ bedsides – but now she thinks it could help innovate and improve care while saving money.  

Nurse Deb is the President of Ault International Medical Management and a pioneer in the medical management field. As an advocate of proactive and predictive case management, she helps patients and their case managers navigate the diagnosis, treatment, and financial aspects of healthcare.

Deb defines and discusses the four types of medical management and explains why she thinks predictive management is the model of the future. She shares how she realized care management could both improve care and reduce costs when done correctly. Deb also emphasizes the importance of employer engagement in health plans, and why they must balance the cost of care with the health of their employees.

What You’ll Learn From this Episode:

  • Why Deb had a change of heart about medical management and how she discovered its potential.
  • The four types of medical management and which Deb finds most effective.
  • The monetary advantage of each type of case management.
  • Why it’s difficult to lead Americans with a carrot or pay them to behave the way you want.
  • How to get employees and employers alike more engaged and compliant in healthcare.

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Episode Transcript:

David:      How can understanding the four modes of medical management help you to deliver exceptionally better value for your clients? We’ll find out, on this episode of Shift Shapers.

Change either paralyzes, or energizes. The choice is yours. You’re listening to the ShiftShapers Podcast. You’re about to learn firsthand from businesses and entrepreneurs who have successfully shaped the shifts in their industries. Get ready to become the change that you want to see. Here’s your host and chief transformation strategist, David Saltzman.

David:        This episode of the Shift Shapers Podcast is brought to you by Captivated Health, a captive insurance arrangement that help small and mid-market companies escape the fully insured marketplace and deliver stability, control and savings without watering down employee’s benefits or increasing their premium share. If you have clients in the educational institution or the engineering vertical, go to our website at captivatedhealth.com or click on the company logo on the Shift Shapers website.

We often think about medical management as something that’s kind of a behind the scenes activity, but it’s starting to move to front stage and for some very, very good reasons. One of the people who’s making that happen is our guest on this episode of ShiftShapers – Deb Ault, otherwise known to those near and far as Nurse Deb. Deb is president at Ault International Medical Management and so with that, welcome Deb.

Deb:           Thank you for having me.

David:        It’s our pleasure. You’ve had an interesting path to get to where you are today and I think that informs a lot of our conversation. So if you wouldn’t mind, would you spend a minute or two talking about how you got to where you are?

Deb:           Well sure, I’m happy to do that. I am first and foremost a registered nurse. That’s how I started my career at the bedside. Worked in the ER, ICU, critical care kind of areas, moved around as a lot of nurses do exploring other areas, home health and doctors office. Landed at a telephonic nurse on call program, which was kind of good because it gave me an opportunity to further my education. It also was my first experience of working with patients over the telephone and I was always intrigued with the kind of impact that you could have not being face-to-face with patients. So that’s how I wound up on the telephone side of working with patients.

I got laid off from there unfortunately when some cost-cutting initiatives came into play. You guys probably remember that time of the market when all of the big hospitals were having all these great big consulting companies come in and show them how to cut their costs. At that point in time, I was very convinced that managed care was the reason that cost-cutting was necessary on the provider side. I was very vocal about it and was involved in the nurses’ union. I had been interviewed for television, spoke with many politicians about the cost-cutting that hospitals were doing, and became more and more dissatisfied at the bedside because of that, and feeling more and more pressure like a lot of nurses do to compromise patient care. So I was very anti-managed care, but then when I got laid off, having been so vocal about the cost-cutting that the providers were doing, I found myself having difficulty getting a job at any of the other large hospitals in the city.

So my husband pushed me to apply for managed care position. I kept telling him, “No, they’re the evil ones. They’re the reason were having to cut all these costs.” To make him be quiet, I applied. Fortunately, I wound up at a company that was nurse-led and they were following the teachings of Catherine Mullahy and were doing good case management. The problem that they were having was that they were having difficulty explaining to the bean counters, especially in the self-funded major medical health plan world which is where I am, how that was having a positive financial impact for the plan.

I’d continued my education, and I’d gotten my bachelors in business with a minor in math and statistics. So they hired me essentially to learn case management because of that math background and being able to come in and define savings and explain how getting the right patient to the right care at the right time in the right place would naturally result in the right price for the health plan. So that’s how I started my career in managed care and have the typical spinoff sell merger acquisition moving around in different roles in the managed care industry.

Then about 15 years ago, we had gone through one of those buyouts by venture capital and said to my husband, “This is crazy. These guys are not the kind of people that I want to work for. I’m going to have to look for another job.” He said, “No I think it’s time that we do this for ourselves.” So he convinced me to open AIMM about 15 years ago. We’ve been working in the self-funded major medical health plan arena ever since.

David:        To level set a little bit, you break managed care down into four different types. I’d like to take a moment and explore each one of those. The first one is reactive. What does that mean?

Deb:           Reactive is what we kind of traditionally think of when we think case management. So something happens. A patient becomes ill, has a catastrophic condition. They’re diagnosed with something or they’ve had a huge amount of claims spend happen. Then a case manager steps in to react to that. I affectionately call this also a “paid historian” model, because once that diagnosis has already hit, once those claims have already arrived, it’s very difficult to do anything that’s going to be impactful on the clinical quality of care or on the financial control side. So reactive is kind of responding to things that have already happened, often very far back in the timetable.

David:        The next piece you talk about is real-time. What is that and how does that differ from reactive?

Deb:           Real-time hit the market about 20 years ago. It was predominantly nurses who were doing case management who were frustrated with reactive and who were saying, “Listen, I need to get out in front of this. I need to be able to respond right away.” So as soon as somebody gets diagnosed with cancer or MS or any kind of life altering condition, I want to get involved real time at that point in time. That was more effective than reactive, but not still not everything that it possibly could be.

Reactive – when I think of the reactive model and the impact that it’s going to have on clinically a patient, it’s minimal. The horse is already halfway across the stream; telling them to change paths is difficult at that point. It’s disruptive in a negative way. They’ve already established relationship with care providers. Financially, what you see happen in groups that have reactive case management is they follow trend. If the trend increases 8%, they’re going to financially perform at 8%, 9%. If they’re really lucky, maybe 7%.

When you get into real-time and you start getting engaged with members at the time of diagnosis, then you can begin to have an impact clinically because you’re educating them. At least getting them to understand what questions they need to be asking their care providers. You’re also able to have more of a steerage in that which specialists are going to be chosen. Yes, maybe the doctor who diagnosed them with cancer told them a doctor he was going to refer them to but they haven’t seen that doctor yet. So if there’s another option that they need to be thinking about, they’re more open and receptive to it.

It also has a better impact financially. So those groups typically are going to beat trend not by a huge amount, but they will come in a couple of points under trend in comparison to everybody else in the market. So it does have an impact. It’s better than reactive, but it’s still event-driven.

David:        Then there’s proactive, which I guess means what it sounds like, but how does that happen in practice?

Deb:           So proactive is, if you remember a couple of years ago, we went back to expanding the list of things that require precertification. So there’s been this big back and forth and back and forth in the market for things like imaging studies. So maybe you get a pre-cert request for somebody who’s going to have an MRI and that MRI is highly suspicious of a catastrophic diagnosis. At that point, you get the member engaged. Start having conversations with them and say, “Hey I have gotten your precertification completed. When will you get the results back?” You’re building rapport much earlier in the course of illness.

Now, of course, sometimes those will come back no big deal. It was negative. Everything is benign. It’s fine. They’re not going to need any treatment. So, yeah, there is a little bit of “waste” there, but the benefit of doing it that way is in those instances where it does truly come back important, catastrophic, serious, you’ve already got rapport built with the patient. They already know that you’re there to help them. Making sure that they’re getting the right care, making sure that the timing is flowing smoothly, making sure that they’re getting care in the right place.

So because you’re able to do that, you’re able to have a more active role in helping them get the care that’s right for them. Doesn’t always mean that they’re going to do what I would do or what you would do David, but they’re going to make an informed decision. They’re going to have all of the tools and resources and support and guidance at their fingertips to help them through that. So you’ve become proactive because you’ve gotten in front of that date of diagnosis. Something is suspicious, there’s a high likelihood. There’s a potential coming down the pike, now we’re being proactive about getting that person engaged.

David:        Now a word from our sponsor.

Captivated Health is a single source solution for your clients and prospects in the education and engineering verticals. The founders of Captivated Health have 35 years’ experience working with healthcare and benefit clients. Over that time, they’ve developed a keen understanding of the unique problems mid-market clients experience. Frustrated by a lack of control, the unpredictability of ever-increasing healthcare costs and the pressures and regulations of the Affordable Care Act, these groups have been adrift in the fully insured commercial marketplace – until now.

Captivated Health has built a program that solves those problems and does so with virtually no disruption to employees while saving clients millions of dollars. We wanted you to be among the first to know that Captivated Health is building a national distribution partner network so you can bring this cutting edge solution to your education and engineering clients that you advise. To learn more about Captivated Health Solutions, go to our website at www.captivatedhealth.com or click on our logo on the ShiftShaper’s website.

So then we go from being in front of the date of diagnosis to actually in front of the diagnosis altogether with the fourth piece which you call predictive.

Deb:           Absolutely. I love predictive and I think that it is where everybody should be and probably everybody will be before too much longer. There are great tools out there and have been for quite a while. The problem has been that not a lot of people have wanted to adopt them. Some people are averse to the cost even though it’s a minimal cost to do any kind of claims data mining or predictive risk modeling. There’s been questions about, “Is this clinically valid? Is this mathematically valid?” I think we’ve overcome all of those hurdles with a couple of products in the industry. So you can now begin to actually do predictive risk modeling. Guess what? You can initiate case management based on prediction.

Again, is every person that you predict is going to spend $25,000 in claims next year, definitely going to spend $25,000 in claims next year? No. Nobody has got a crystal ball that’s 100% accurate, but it’s worth the time and energy to invest in doing predictive risk modeling and the medical management that goes along with it. That’s really where you can begin to have a maximum impact on people’s lives, on what happens to them clinically and what happens to the plan financially.

So with the proactive model of medical management, we talked about where a group is going to perform in comparison to trend. You can really begin to have a good impact on spend. If you do predictive, then you can not only have the impact of proactive which will continue, but you can also flatten that trend out long term. So if you think of reactive as being right about trend, real-time slightly below trend, proactive cutting trend off, cutting that in half or stopping the flow of dollars, and then predictive as leveling that out long term.

David:        You say there’s products that are out in the market that do a pretty good job with predictive modeling. I remember years ago when I was with Humana. It was one of the things we chased and the number we always looked at was R squared – more colloquially I guess, how often you predict correctly. Where are those numbers at today? I know there’s a lot more data that’s flooded into those models that should have increased that.

Deb:           So it depends on whether you’re looking at clinical prediction or financial prediction. Most of the ones that are really worth using are going to be at least 80% accurate both clinically and financially. There’s always going to be that 20% the guy who drives his Lamborghini around the curve too fast and ends up in the side of the mountain that you can’t predict. At least 80% accuracy should be the threshold that you’re looking for as you’re shopping for those.

David:        So one of the things we talk about a lot on the podcast – and you may have heard us talk about it – is compliance, and how you get folks to actually engage. I know that you feel that Americans are kind of unique in that they don’t really respond to carrots. So that being the case, what do you use? Sticks, or orange sticks, or some combination of the two or…?

Deb:           It’s different from group to group to group. I think that’s one of the key characteristics. If you want to be successful in continuing to provide health benefits, but being able to do that in a financially feasible way, you have to understand your population and what works for them. Don’t get me wrong. I’ve got a group or two that their members will respond to a drawing for a $5 movie coupon. But those are pretty few and far between. Generally speaking, as Americans, we’re pretty affluent. Even offering somebody a big-screen TV may not be enticing to them. For the most part, you’re not really able to buy behavior. You may be able to buy participation, but participation isn’t going to generate the outcomes that you want if people don’t change their behavior. So it’s a real challenge.

I think the only thing that has truly worked in my experience… what I’ve seen work is an intensive education campaign and a culture shift within the organization, the employer organizations, since the employer is the one that’s providing the health plan. When you begin to get that happening, then your engagement rates go up. Engagement results in behavior change. Behavior change results in cost reduction. So it’s really appealing to the nobler motive as Carnegie would say. That seems to work best with the most of our groups or most Americans.

In other countries, things are different. As we travel the globe, we find that different cultures have different motivations. Most of the people that I work with…again, I work in a self-funded major medical health plan arena. So these are all people who are gainfully employed and they can pretty much afford the things that you would offer. Although I will tell you that I have seen groups be very successful, especially with the younger generation….so if the population of the plan is very young, offering incentives for things like extra days off, because we find that a lot of people in that millennial generation are seeking better work life balance, but again that’s not always as effective at getting the behavior change which is the real outcome that you’re striving for.

So it really boils down to education and changing the culture of the organization. It really has to start at the top of the organizations. So the C suite has to be on board and they have to be focused on this. They have to be focused on a combination of a couple of different things. They have to be focused on how do we improve the health of our members and simultaneously control the cost of our health plan. So that’s a balance that they have to be focused on. If they focus just on cost, we’re back in the old HMO world and that’s not going to get us where we want to be.

If they focus just on health – especially if the tenure of the population isn’t a long one – they may be investing in making that person healthy for their competitor when they leave and go to work for somebody else. So there’s a real balance there. The C suite has to be involved in setting up what that balance is going to be for their organization.

David:        There’s a lot of conversation going on around a topic that you may have bumped into called noncompliance. Where do you stand on noncompliant and working with noncompliant individuals as a tool to help move trend and to move claim spend?

Deb:           So that’s an interesting topic because as nurses we work with patients. The whole noncompliance issue is continual. You have to really step back and start thinking about things like Prochaska method and where somebody is on the stages of change scale and those kinds of things. There’s noncompliance for a lot of different reasons. We have to determine whether that noncompliance is what I call the result of free will. “I’m fully educated about the ramifications of my choice but I’m going to make this choice anyway,” versus noncompliance that comes from a position of lack of knowledge.

When it’s coming from a position of lack of knowledge, there’s a lot that can be done, by case management and in particular, medical management, to make sure that that person is equipped with all of the information, resources, support, guidance that they need so that they can make the best choice possible. I talked a little earlier about the HMO world. Most self-funded health plans at least don’t want to dictate treatment. They don’t want to be in the business of practicing medicine for their employees. They’re in the business of making widgets or whatever their core business is. They do want their people to have the information to make the right choices for them.

So distinguishing noncompliance into two different categories, the categories I call it a free will versus lack of information and education and then applying Prochaska method and motivational interviewing techniques and things to make sure that that patient has everything that they need.

David:        So we’ve got about a minute or two left. We always like to wrap up by asking our guests where they see the future. You certainly are out on the edge and doing some things that other folks maybe haven’t embraced yet. Where do you see your field going? Where do you see the future?

Deb:           I really feel like we’re at a great crossroads right now. I’m not sure that everybody in the industry recognizes it. I think especially with everything that’s happening politically, one of two things will happen. Either we, meaning those of us in the industry, will step up and revolutionize healthcare or we’ll end up with a single-payer nationalized healthcare kind of system. I think were at that point that in the very short term we’re going to have to make a decision as a country and go one way or the other.

I think that we as an industry have the capability. We have the tech. We have the mind power. We have the resources to truly revolutionize healthcare. I think that the tools are there. The question will become whether those who are providing health plans, the employers that are sponsoring health plans will get on board with it and will grasp it, and whether the big carriers will embrace it or not. Whether the big hospital providers will embrace it or not. I think that’s yet to be seen. I think we’ll go one of two ways. We’ll either revolutionize it and it will be a beautiful thing or we’ll end up in a nationalized system.

David:        Well that certainly is a stark choice and we’d love to have you back as that unfolds and talk to you more about where the direction is. Deb Ault, president at Ault International Medical Management. Nurse Deb, thanks for sharing your expertise with the Shift Shapers audience.

Deb:           Thanks for having me. I look forward to talking again sometime soon.

The Shift Shapers Podcast is a production of Strategic Vision Publishing and David Saltzman. This podcast may not be reproduced in any form, in whole or in part, without the express written permission of the producers. All rights reserved.

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Today’s advisors are being asked to do more . . . and often – with less. Can a CRM help increase your effectiveness along with your practice’s efficiency?
Commission compression, client expectations of broader and deeper service levels and an ever more complex industry have all put pressure on benefit advisors. In many practices, this has had a significant effect on profitability. On this episode of ShiftShapers we explore the wide world of CRM systems. With a little bit of work, the right system can help your practice stay focused while delivering better service.
Ryan Pinney, President of Insureio, joins us on this episode to talk about how new CRMs targeted specifically at insurance agents, advisors, and other professionals are changing the practice management landscape. A great CRM can save you from spending the bulk of your time managing client data rather than engaging with clients themselves.

Ryan talks about how some of the most successful agents have been adopting new technologies for the past decade, giving them a leg up. We discuss how the average age of agents in the insurance industry affects our willingness to integrate new technologies into our practices, and what to look for in a CRM if you’re new to the tech.

CRMs can help you maximize your sales time, keep up with clients, and prospect more effectively. Ryan describes several different CRMs and the rules-based software you can use to streamline your entire selling process. We also touch on why you must get a CRM that is explicitly secure enough for HIPAA guidelines.

What You’ll Learn From this Episode:

  • Why many salespeople only spend 40% of their time selling (when they should be spending 70-90%).
  • How operational change has been slower to effect the sales cycle than other aspects of the business.
  • How agents or advisors can begin putting their existing business onto a CRM.
  • The pros and cons of cloud-based CRMs and hardware-based CRMs.
  • The essential security questions you must ask before choosing a CRM to ensure that clients’ data is as secure as possible.

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On part two of this special, post-election edition of the ShiftShapers podcast, we discuss policy ideas that may be seeing a resurgence based on the election outcome and whether these ideas can really bring down costs in the healthcare marketplace.

Jessica Waltman, Principal at Forward Health Consulting and our resident expert on all things legislative and regulatory joins us for part 2 of our look at healthcare in this post-election period.

We discuss the theory being floated that an individual healthcare marketplace will control costs better than the employer-based system currently in place.  We are also hearing a great deal about selling across state lines. Jessica walks us through a practical example of how that theory actually performed in the Georgia market. And finally, we touch on the third rail in healthcare: dealing with hyperinflated and runaway costs on the supply side.

We also explore whether to expect any initiatives that address one of the largest cost drivers – prescription drugs. We wrap up with a serious discussion of the timing – and the time – it will take to unravel PPACA and make meaningful serious reforms, as well as the possible perils of acting too quickly.

What You’ll Learn From this Episode:

  • Policy ideas being proposed from conservative economists on how best to structure the health care system.
  • A practical example of whether purchasing healthcare across state lines encourages competition and brings down the price.
  • Why rural markets are inherently difficult to serve by healthcare providers.
  • What President-elect Trump has hinted about controlling drug prices.
  • The strategies in place to address the main cost drivers on the supply side.
  • Whether value-based pricing is the first step in reigning in runaway facilities costs.
  • What advisors should do in preparation for the upcoming enrollment period.

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On part one of this special, post-election 2-part edition of the Shift Shapers podcast, we look at the reality of the “Repeal and replace” strategies and tactics being discussed by the new administration and other health care constituencies.

Jessica Waltman, Principal at Forward Health Consulting and our resident expert on all things legislative and regulatory joins us for a two-part wrap-up on how November’s election results will affect the health care and employee benefits universe.  In part 1,  we focus on whether full-scale repeal and replace will happen or if other realities will make large-scale change a more complex and messier process.

For six years, the Republican party has put forward the idea of replacing the ACA and replacing it with a suitable option. With control of the Executive and both houses of Congress, the Republican majority will have an opportunity to make their move. How will HHS Chairman-designate Dr. Tom Price change the debate? Will the House Republican’s plan gain wide acceptance? And how can these changes be effected without disinsuring millions?

There are various schools of thought in play when it comes to making changes to the ACA. Jessica walks us through the opposing viewpoints and discusses the pros and cons of the various proposals. She provides context on just how they will impact consumers, businesses, and advisors alike.

Changing the law will not be a simple process. The ACA is an extensive and complex piece of legislation. Abrupt changes can have unintended consequences that impact health care access, the economy, and potentially the mid-term elections.

Listen in to find out what Jessica suggests the Trump administration can do right away that would positively impact businesses.

What You’ll Learn From this Episode:

  • The strategies and tactics that are being considered for “repeal and replace”.
  • How the appointment of Dr. Price as new Secretary of HHS will impact the “repeal and replace” discussion.
  • How Dr. Price’s “Empowering Patients First Act” will meld into any new plans.
  • Whether selling across state lines is a practical idea in today’s environment.
  • The strategies in place to address the main cost drivers on the supply side.
  • How regulatory changes can be made without eliminating effective provisions that are working well.

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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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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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