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

Josh Luke is a man with many vantage points on our health care system: author, public speaker, healthcare futurist, and hospital administrator. He believes that the current healthcare system is irreparable. So, what are his thoughts about how we move forward and craft something that actually works?

What You’ll Learn From this Episode:

  • Why affordability + greed + millennial culture = today’s dysfunctional system.
  • Telehealth as a driver.
  • Lack of transparency in the acute hospital sector.
  • The current system makes no sense – especially to millennials.
  • The four largest lobbying groups don’t want change.

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How can plan participants use transparency tools to stay in network, but still find less expensive, higher quality care? Bill Hennessey is CEO at Pratter, Inc. and says the data proves – without argument – that providing transparency tools that are easy to use will help employers and their employees bust through the price/quality walls.

What You’ll Learn From this Episode:

  • What are the real components of a hospital charge?
  • Why there is such unreal variation in pricing.
  • Health care vs. Health Insurance.
  • Why we have a broken, rigged system.
  • What laws have to change.

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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

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Mark Gaunya and Jennifer Borislow continue their discussion from last episode about why healthcare is so expensive and share their ideas to slow rising prices. With the release of the second edition of their book Bend the Healthcare Trend, Mark and Jennifer are advocating for consumer-driven healthcare as the solution to rising expenses.

In analyzing the healthcare system, inflation greatly outpaces the general economy. Our guests explain why the industry’s prices rise so much faster than those of other industries, largely due to a lack of transparency or tangible competition.

Opportunity will grow from greater industry transparency and responsibility, as consumers will save money and maintain better health. We need to look beyond physical health and appreciate mental, spiritual, and financial health as well.

What You’ll Learn From this Episode:

  • The three essential principles of healthcare’s oncoming trend: Transparency, Responsibility, and Opportunity.
  • Why healthcare is the only industry where consumers don’t shop around.
  • What opportunities flow from responsibility and transparency.
  • The difference between wellbeing and wellness.
  • Why there has been an uptick in interest around self-insured plans. 
  • How companies of all shapes and sizes can approach a self-funded health plan, and how an advisor can approach that conversation.

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A shift in communication and interaction with prospects and clients is the subject of Jeremiah Desmarais’ new book ….SHIFT. If you want to compete in today’s market, it is a must read.

Jeremiah is an old friend who always seems to be able to see –and oftentimes define – the cutting edge in communications strategies. In this interview, we will discuss everything from the Theory of Reciprocity to a one-line email that will deliver amazing results – if you can keep from messing with the formula.

We also discuss methods to drive greater engagement – a subject we talk about a great deal these days. Jeremiah explains why webinars are a great tool – but are more suited for B2B sales. We delve into how advisors can get and take advantage of media and much, much more.

What You’ll Learn From this Episode:

  • What are the digital shifts that are happening that you need to be aware of.
  •  What does the Theory of Reciprocity mean and giving value unconditionally.
  •  What is the problem with email and how we can approach it differently as a communication medium.
  •  How you can be more effective interacting with and getting on media platforms.
  •  Why webinars should be an integral part of your business.

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Mark Gaunya and Jennifer Borislow continue their discussion from last episode about why healthcare is so expensive and share their ideas to slow rising prices. With the release of the second edition of their book Bend the Healthcare Trend, Mark and Jennifer are advocating for consumer-driven healthcare as the solution to rising expenses.

In analyzing the healthcare system, inflation greatly outpaces the general economy. Our guests explain why the industry’s prices rise so much faster than those of other industries, largely due to a lack of transparency or tangible competition.

Opportunity will grow from greater industry transparency and responsibility, as consumers will save money and maintain better health. We need to look beyond physical health and appreciate mental, spiritual, and financial health as well.

What You’ll Learn From this Episode:

  • The three essential principles of healthcare’s oncoming trend: Transparency, Responsibility, and Opportunity.
  • Why healthcare is the only industry where consumers don’t shop around.
  • What opportunities flow from responsibility and transparency.
  • The difference between wellbeing and wellness.
  • Why there has been an uptick in interest around self-insured plans. 
  • How companies of all shapes and sizes can approach a self-funded health plan, and how an advisor can approach that conversation.

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Nine years ago, Mark Gaunya and Jennifer Borislow wrote “Bend The Healthcare Trend” to explore how healthcare consumers could counteract the damaging effect of a system with misaligned incentives, opaque pricing schemes, and unnecessary complexity. They are about to release the 2nd edition of their definitive book and ShiftShapers talks to them about how much has changed; and how little has changed!

The authors believe that what has not changed is that consumerism and transparency are still the answer to an industry that remains unnecessarily confusing, even for many folks within the industry. The average layman stands no chance in a system created by the rule makers, for the rule makers.

Our guests lay out how the government, Big Pharma, hospital systems, and health insurance companies are incentivized to stop price deflation and maintain complexity.

The second edition is peppered with actual examples of how they have used the principles in the book with their clients – and the success those clients have enjoyed in gaining control over their plans while delivering a climate of health and well-being for their employees.

Mark and Jennifer also outline what has changed since the first time they wrote about consumer-driven healthcare in 2009. The lack of transparency in the market is still an issue, but organizations are starting to deliver tools that aid consumers in making choices.

Be sure you tune in for Part 2 next week!

What You’ll Learn From this Episode:

  • What prompted Mark and Jennifer to write the first edition of their book in 2009.
  • What has changed since then and why they’ve felt the need to update amidst our unsettled healthcare environment.
  • Who are rule makers that construct our healthcare system.
  • What it will take to de-isolate consumers from the cost of care.
  • How employers can take advantage of new legislation to provide healthcare to employees.
  • What it will take for more consumers to demand transparency.

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The move from “wellness” to “wellbeing” requires a more holistic approach which includes helping employees become financially well. Understanding the need and bringing the right technology to employers can help advisors expand their offerings and differentiate themselves.

Chris Whitlow of Edu(k)ate joins us to talk about the need, the approaches and how technology and unbiased financial advice are helping companies support all of their employees with these essential skills regardless of financial status.

Technology, data collection, and actionable information enable companies to provide scalable solutions for helping their employees feel more confident with their money. Encouraging financial wellness and literacy in the workplace allows employees to take care of their finances out of the office and feel confident when making impactful financial decisions. 

In this interview, we begin by defining financial wellness and identifying some of the common obstacles that prevent employees from achieving it. We also discuss why this holistic approach to employee engagement is essential for productivity, and why your clients should foster a corporate culture that makes it safe to ask questions about something as integral to daily life as money.

What You’ll Learn From this Episode:

  • The new definition of financial wellness clients are adopting.
  • Why the scale and need for financial guidance demands new approaches.
  • Why traditional resources for financial advice are no longer enough to help employees make good financial decisions.
  • The challenges employees and employers face due to a lack of individualized financial guidance. 
  • How technology is changing to help meet the need for unbiased financial advice.
  • How employers can drive engagement.

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Dr. Keith Smith believes that healthcare pricing in the United States is “scam” — and he’s working to change that. He is the medical director and managing partner of the Surgery Center of Oklahoma. Keith’s outlook on transparent healthcare pricing is a valuable one, especially since he’s had several years putting it into practice. This is part 2 of our two-part episode series on transparency – find part one here!

Over 7 years working in big hospitals, Keith saw the price of medical care rising while the quality of care suffered. This inspired Keith and his business partner to start a private practice founded on transparency, with prices and outcomes shared with everyone. To remain true to their pricing, Keith and his business partner decided they could not work with government programs. They firmly believe that the only way to move to a truly free market is to be completely transparent with healthcare prices, and to deliver better quality care at a lower cost.

Keith discusses his journey as well as the challenges he and his partner had to overcome along the way. We also explore the disruptive consequences that his transparency is having across the country, leading patients (who bid for their non-emergent surgical care) to Oklahoma.

What You’ll Learn From this Episode:

  • How Keith started his transparent pricing surgery center.
  • The pricing structure Keith and his partner use for their medical services.
  • Why current pricing practices are a scam.
  • Why hospitals should not have non-profit status.
  • The disruptive effect of posting his prices.
  • How the Free Market Medical Association works.

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Transparency is the single topic with the most potential to transform every aspect of health and health insurance. We’ve decided to devote two episodes to this potentially innovative topic.

For part one our guest is Ralph Weber, President and CEO of MediBid. Ralph is a passionate subject matter expert and serves as a member of NAHU’s Healthcare Cost and Quality Transparency Workgroup. In this interview, we explore his belief that current healthcare pricing schemes purposefully withhold information from consumers, and why Millennials in particular won’t accept the current status quo on transparency (or lack thereof).

Ralph also describes the effects transparency has on the U.S. healthcare system, the marketplace, and the competitive environment. He shares why transparency alone won’t affect the needed changes to our healthcare system. We also learn why some hospitals charge more for the same type of treatment than others as we discuss the differences between static and dynamic pricing.

What You’ll Learn From this Episode:

  • Ralph’s journey in the health insurance space.
  • The difference between dynamic and static pricing and its effect on the consumer.
  • How Ralph defines transparency.
  • Whether or not the most expensive care is the best healthcare.
  • What the future of transparent pricing and healthcare services might look like.

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