EP309: FFS Providers Getting Locked Out of Referral Flows, Right Now, As We Speak, With Jeff Hogan

This episode is a tale of what happens when some employers decide to open up a few virtual front doors and when these virtual front doors lead only to referrals to providers who are willing to be accountable and offer financial predictability. That's what these employers want, after all. They want accountability and financial predictability.

Many employers now have access to all claims databases and other data like the RAND 3.0 report. Therefore, employers can and are using this information in a big way to steer their plan member populations.

Given these goings-on, some slower-moving providers could easily find themselves on the outside looking in. So, who are those providers who are or will be getting shut out of referral flows? They're definitely FFS-centric, but they could be a large health system, an urgent care center, or a hospital-owned PCP.

In this health care podcast, I speak with Jeff Hogan, the northeast regional manager for Rogers Benefit Group and also president of Upside Health Advisors. We talk in this episode not about what might be theoretically possible but about what is happening right now.

You can learn more at jhogan@rogersbenefit.com and connect with Jeff on LinkedIn.

Jeffrey Hogan is the northeast regional manager for Rogers Benefit Group, a national benefits marketing and consulting firm. Jeff has been with Rogers Benefit Group for 30 years. Additionally, Jeff operates a consulting firm, Upside Health Advisors, where he provides expert witness services on health care–related litigation, is a consultant to payers and large provider groups for product development and launch, and is a resource to employers desirous of implementing strategies to manage their health spend. Jeff is focused on health care payment reform, health policy, care coordination, value-based health care, health care quality, and precision medicine.

Jeff regularly appears on national forums focused on moving to value-based health care and is actively working to promote health care–related transparency measures in the market. He serves as the group's liaison to the National Alliance of Healthcare Purchaser Coalitions. Jeff is the regional leader for The Leapfrog Group. He is also one of the coordinators of Connecticut's Moving to Value Alliance.

01:43 What are self-insured employers doing right now to impact referral flows? 03:29 Are any virtual tech companies moving in on the local provider space? 07:46 "What we're trying to do … is to help the member have the best outcome." 10:32 "It's a continuum, if you will." 10:44 "There is a fairly significant gulf between providers … and, say, a COE [Center of Excellence]." 11:13 "What is value for employers coming out of COVID? Accountability and predictability." 13:40 What are second-order effects? 14:29 "People like and want better access." 14:46 "Fee-for-service providers fear the informed health care consumer." 22:19 "Many of the brick-and-mortar providers are realizing that they have to up their game." 24:52 "Things will change." 25:07 "People not only want convenience, but they want safety, they want data." 26:11 "We are at an inflection point … After 35 years in the business, I really finally feel like we've broken through." 27:31 "This requires people to really think; it requires employers to actually know what their biggest problems are." 29:53 "We can't go back to the fragmentation of fee for service." 30:25 "Data is critical."

You can learn more at jhogan@rogersbenefit.com and connect with Jeff on LinkedIn.

Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

What are self-insured employers doing right now to impact referral flows? Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

Are any virtual tech companies moving in on the local provider space? Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"What we're trying to do … is to help the member have the best outcome." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"There is a fairly significant gulf between providers … and, say, a COE [Center of Excellence]" Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"What is value for employers coming out of COVID? Accountability and predictability." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"People like and want better access." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"Fee-for-service providers fear the informed health care consumer." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"People not only want convenience, but they want safety, they want data." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"We are at an inflection point … After 35 years in the business, I really finally feel like we've broken through." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"This requires people to really think; it requires employers to actually know what their biggest problems are." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"We can't go back to the fragmentation of fee for service." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth

"Data is critical." Jeff Hogan of #UpsideHealthAdvisors and #RogersBenefitGroup discusses #FFS providers in our #healthcarepodcast. #healthcare #podcast #digitalhealth