Self-Funded

"If you ask the surgeon how much time they have to spend thinking about the business side of their practice, it's too high... Let's let doctors be doctors." - Ryan WellsMy guest this week is Ryan Wells, Founder and CEO of Health Here. Ryan joins me to explain why the key to fixing the broken doctor-patient relationship is getting providers out of the debt collection business.We explore how Episodic Care (bundled payments) can finally align the financial incentives of self-funded employers and high-value specialists. Ryan breaks down how his platform automates payments, getting surgeons paid in under 15 days while eliminating patient liability entirely.We dive deep into Ryan's background in the OR, the lessons learned from the "Metal on Metal" hip recall, and why we need to move from "open enrollment confusion" to real-time, event-driven patient navigation.If you are tired of administrative waste and want to see a model where doctors focus on care instead of claims, this episode is for you.Thank you to our 2026 sponsors!ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit ParetoHealth.com to learn more.Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.Chapters:(00:00:00) Let Doctors Be Doctors(00:03:04) Ryan's Journey: From Anthropology to the OR (00:07:00) Lessons from Medicare’s Acute Care Episode Demo (00:10:46) Defining the "Bundle" vs. Fee-for-Service (00:13:00) Value-Based Care = Outcome / Cost (00:16:14) Why Orthopedics is the Perfect Starting Point (00:18:32) Moving from "Elective" to "Discretionary" Care (00:21:38) The Navigation Problem: Open Enrollment Fails (00:31:48) Owning the Payment Rails: 15-Day Payments (00:37:38) Automating the "Outlier Workflow" (00:41:35) The "Metal on Metal" Hip Recall & Registries (00:48:30) Expanding to Cardiology and Bariatrics (00:53:03) The Moonshot: Removing the Business Burden from MDsKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Will Johnson, founder and CEO of Gyde, is building an AI-native insurance, wealth, and health brokerage to modernize agency distribution. He explains what AI-native means for agencies. Topics include automating renewals, using AI to multiply broker capacity, a partner-activation acquisition model, rapid Series A momentum, and a moonshot to unify insurance, wealth, and health advisory.

Chris Leverett, EVP and Managing Director of Employee Benefits at TexCap who overcame high-functioning alcoholism while keeping career and family intact. He recounts the slippery slide from social drinking to dependence. He describes a family crisis that sparked change. He explains trading alcohol for endurance sports, daily recovery routines, and strategies for navigating alcohol-heavy industry events.

This week features Simon Spurr, Founder of VivaScore, a digital health visionary, and Chris Burns, a seasoned benefits advisor with a rich history at firms like Mercer. They dive into the revolutionary rPPG technology that allows users to assess vital health metrics using just their smartphone camera. Discussing its potential to transform primary care, they explore how this platform helps employers identify health risks early, boosts engagement, and creates personalized care pathways—all while paving the way for a proactive approach to wellness.

Kyle Minick, Vice President of Employee Benefits at Summit Financial Group, tackles the alarming gap in benefits education for HR professionals. He discusses universities' minimal focus on healthcare strategy and the creation of a six-week accredited course to address this failure. Kyle highlights the struggles of reference-based pricing in Texas and the misaligned incentives of using Medicare rates as a benchmark. He aims to equip students with the skills to audit vendors and demand better health plan management, significantly changing the HR landscape.

In a thought-provoking discussion, Chris Yarn, founder of Walk On Clinic, reveals why convenience is critical in healthcare. He shares his innovative journey from insurance broker to creating a direct primary care model that delivers healthcare directly to employees. Chris exposes the shortcomings of traditional clinics and highlights the success of mobile onsite care, boasting double the industry utilization rates. He emphasizes the importance of early detection, supported by his personal cancer experience, and offers insights on proving ROI through real claims data.

If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.This month, we’re doing something a little different to close out 2025. Instead of just looking back at December, we are ranking the biggest healthcare stories of the entire year on a Tier List, from "Not Impactful" to "Super Impactful." We cover everything from the FTC suing the Big 3 PBMs and the J&J fiduciary lawsuit dismissal to the "bloodbath" of 2026 renewals and the explosion of GLP-1 usage.Plus, we debut a new "Explain Like I'm 5" segment where I break down complex concepts like Reference-Based Pricing, Captives, and Stop-Loss using simple analogies involving candy shops and dirt bikes. Finally, we answer a listener question about building confidence as a young professional in the industry.Chapters:0:00 - Intro: Last Year in Healthcare0:51 - Tier List19:05 - Explaining Insurance To A 5-year-old24:24 - Ask Spencer Anything

Dutch Rojas, a healthcare entrepreneur and strategist, dives into his vision of 'co-opetition' in healthcare. He highlights how hospitals exploit price arbitrage, charging significantly more for the same services, harming independent practices. Dutch discusses the need for independent providers to unite, leveraging collective buying power for benefits. He also shares insights on creating a 'Healthcare Commodities Exchange' to normalize pricing and why CFOs should lead healthcare decisions. His journey from the Netherlands to the U.S. adds a personal touch to his bold ideas.

Will Bruhn, CEO and co-founder of Global Appropriateness Measures, sheds light on a shocking statistic: 21% of medical care is unnecessary. He discusses how traditional quality metrics focus too much on outcomes rather than appropriateness, leading to wasteful practices in healthcare. Real-world examples, like unnecessary spinal fusions and the surge in Friday afternoon C-sections, reveal financial incentives at play. Will also outlines how data can steer patients towards high-value care, ultimately aiming to eliminate this wasteful spending.

Cory Morin, Co-founder of Benji Card, is a fintech entrepreneur transforming healthcare payments with his innovative virtual wallet strategy. He discusses how giving care coordinators instant access to funds can significantly lower medical claim costs. Cory reveals how Benji Card enables immediate payments to providers, leading to substantial discounts for employers. He believes this model could make traditional PPO networks obsolete and predicts a future of tiered zero-dollar benefits in healthcare. Tune in to discover this revolutionary approach to cost containment!