Self-Funded

“To me, a private equity firm should never look at a healthcare vertical and say, God, there's opportunity there. That means that there's profit exploitation to be had in those areas.” - Taylor Rogers Taylor Rogers, former professional baseball pitcher turned insurance consultant, joined me this week for a podcast focused on profit exploitation in the current healthcare system, and what we need to do as an industry to bring back competition and lower prices.  There are a huge number of people in this space who used to be college or professional athletes, so I was excited to hear what led to Taylor’s baseball career and what also led him to insurance.  Competition is an inherent component of capitalism, one that leads companies to try to lower prices as much as they can to appeal to consumers, but it’s incredibly absent from this field. Join Taylor and I this week on Self Funded as we try to figure out why.  Chapters: 0:00 - Meet Taylor 07:38 - Consistency, in Baseball and Comedy 09:36 - The Importance of Failure in Growth 12:50 - The Evolution of Insurance Consulting Strategies 18:00 - bridging the gap with accessible communication 23:28 - Navigating Risk Management Challenges in Insurance 25:01 - Guiding employees through the healthcare system 31:26 - Limitations of 24/7 emergency care navigation 35:16 - Strategic guidance and business acumen in consulting 46:29 - The Potential of Direct Primary Care Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #insurance #healthcare #consulting #businessstrategy #privateequity #affordablehealthcare #riskmanagement #selffunding #carenavigation #consultingpractice #podcast #selffunded insurance, healthcare, consulting, business strategy, private equity, affordable healthcare, risk management, self funding, care navigation, consulting practice, podcast, self funded

“You can have the same provider, same treatment, two different locations, different outcomes.” - Gentry Lynn Gentry Lynn, VP at Healthcare Bluebook, joined me this week to discuss what it means to actually make an impact in this industry, why there’s so much cost variance between locations, and how we can more effectively engage members to use new solutions. One of the key points of our discussion was that there are actual health outcome and cost ramifications to which location patients get their care from, even if the provider is exactly the same.  The impact of what we do is a frequent topic of this podcast, and in this episode we dive deep into what it means to try to make positive change in such a huge and frequently old-fashioned industry. Chapters: 0:00 - Meet Gentry 02:49 - Gentry Lynn's Journey into the Insurance Industry 19:24 - Remote Collaboration and Specialization in Our Industry 23:19 - Healthcare Cost and Quality Transparency Tool 31:19 - The Impact of Medical Cost Transparency 37:18 - Evaluating Doctors for Optimal Medical Care 46:11 - Cost Variance By Location 51:59 - Personalized Communication leads to Member Engagement 54:05 - Surprising Disparities in Healthcare Procedure Costs Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #healthinsurance #healthcare #bluebook #employersolutions #costandquality #centersofexcellence #employermindsets #dataintegration #claimvalidation #costvariance #podcast #selffunded health insurance, healthcare, bluebook, employer solutions, cost and quality, centers of excellence, employer mindsets, data integration, claim validation, cost variance, podcast, self funded

“It's like the Wizard of Oz, I think, or The Matrix. You have this veil that as the participant in it for so long, you just don't think about your benefits. But I think when you kind of peel back the curtain and you're looking at the greed of it and how everyone is getting paid on people being sick, it's gross. And I don't vibe with it.” - Durrell Finch Anyone who listens to the show should know by now that I’m a huge proponent of personal wellness, healthy eating, and exercise, which is why I was super excited to have Durrell Finch join me for this week’s episode.  Durrell is a former fitness trainer and the VP of Business Development for BioCoach, a company focusing on employee wellness through end-to-end obesity and diabetes care and prevention.  We discussed some simple and practical ways to better structure workouts, then jumped into our main topic: GLP-1s, the new class of weight loss drugs, and how employers should assess their role in wellness. Join Durrell and I on this week’s wellness-focused episode of Self Funded, and stick to the end to see if I can properly stand up from a criss-cross position! Chapters: 0:00 - Meet Durrell 04:52 - The Healing Power of Movement 16:49 - Improving Performance through Mindfulness and Biomechanics 17:40 - Navigating Covid Challenges As A Fitness Trainer 30:46 - Biocoach: Data-driven Wellness with Personalized Support 38:05 - Fostering Camaraderie and Personal Growth in the Workplace 42:01 - Affordable and Accessible Healthy Eating Strategies 48:50 - The Role of Muscle in Long-Term Weight Loss 51:06 - Promoting Sustainable Weight Loss through Education 53:28 - Structured Weight Loss Program with Drug Progression 58:12 - Financial Implications of Healthcare Choices 01:06:50 - Revolutionizing Health and Wellness with Fitness Tracking Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #ozempic #weightlossdrugs #movement #exercise #wellness #health #fitness #psychology #personalgrowth #mobility #legstrength #biocoach #healing #selffunded #podcast Ozempic, Weight Loss Drugs, Movement, Exercise, Wellness, health, fitness, psychology, personal growth, mobility, leg strength, biocoach, healing, self funded, podcast

"Compliance does not have to be a burden. It doesn't have to be hard. It can be a value differentiator and an opportunity to really help people." - Jen Berman Jen Berman joined me this week to close out our trilogy of compliance episodes. We focused on why regulations exist, the purpose of recent legislation like the CAA, and why it’s important for consultants to learn the compliance process. Jen is the CEO of MZQ Consulting (not an acronym, as we discuss in the episode), a leading provider of compliance solutions in the industry. Recent compliance has shifted the burden onto employers to make sure their plans are compliant, including making sure that their mental healthcare is in parity with normal healthcare.  As Jen said on the episode, compliance is typically viewed as a burden, but for consultants, it shouldn’t be: it’s an opportunity to differentiate yourself in the market and provide a next level of service to employers. Join Jen and I this week for another compliance-focused episode of Self-Funded. Chapters: 0:00 - Meet Jen 2:23 - The Impact of ACA on Healthcare Industry 17:24 - Anticipating Gag Clauses: CAA Compliance Solutions 19:43 - Mental Health Care Should Equal Health Care 27:02 - Employer Investigations 36:23 - Tracking Money Flow and Compliance 41:57 - Gag Clauses and Restricted Access to Plan Information 49:22 - The influential role of compliance professionals 54:53 - The importance of regulatory schemes in healthcare Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #ACA #CAA #healthcare #compliance #regulations #AffordableCareAct #mentalhealthparity #governmentinvestigation #prescriptiondrugdata #gagclauses #complianceprofessionals #selffunded #podcast ACA, CAA, healthcare, compliance, regulations, Affordable Care Act, mental health parity, government investigation, prescription drug data, gag clauses, compliance professionals, self funded, podcast

"When consumers understand that they can get the same level of care at half the price, they feel good about making that decision." - Josh Schreiner “We're actually going to collapse that concept entirely. Everyone's in network from your perspective, from the consumer, from the patient perspective." - Michael Mather Continuing from last week’s theme of compliance and regulation, Josh Schreiner, Chief Product Officer, and Michael Mather, General Counsel, of HealthEZ joined me for a discussion on the effects of the No Surprises Act on the healthcare industry as a whole, and how it affects consultants as they work with employers. At HealthEZ, Josh and Michael have been looking ahead to the future of healthcare and how the recent regulations have impacted that, including a returned focus to consumer decisions in their own healthcare and an increased focus on employer compliance. For consultants, these are particularly important topics as consultant responsibilities shift in response to the legislation. Join Josh, Michael, and I as we break down the No Surprises Act, offering our insights and hopefully some practical guidance on navigating this crucial piece of healthcare legislation. Chapters: 0:00 - Meet Josh & Michael 1:23 - Empowering Consumer Decisions through Healthcare Transparency 5:44 - Navigating Healthcare Compliance 16:22 - Protecting Patients Through The No Surprises Act 23:19 - The High Volume of Disputes 30:39 - Increasing contract disputes impacting healthcare reimbursement 38:05 - Transparent Healthcare Information 40:50 - The Impact of Transparent Healthcare Pricing 50:30 - Gag Clause Attestation and Compliance Challenges 58:34 - Balancing Guidelines and Innovation in Healthcare 1:04:55 - Leveraging Wearables and Data for Personalized Healthcare Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words: #healthcare #transparency #compliance #innovation #selffunded #medicalcosts #consumerinformation #futureofhealthcare #wearables #datadriven #nosurprisesact #regulation #podcast Healthcare, Transparency, Compliance, Innovation, Self Funded, Medical Costs, Consumer Information, Future Of Healthcare, Wearables, Data Driven, No Surprises Act, Regulation, Podcast

“The CAA was the most significant piece of healthcare legislation that we've had since the ACA.” - Sarah Borders Healthcare compliance, especially post-CAA, can be a complex thing for employers to navigate. There’s an increased level of scrutiny on employers, with heavy fees for those who don’t comply.  This week on Self-Funded with Spencer I’m joined by Sarah Borders, co-founder of Benefits Compliance Solutions. Here are a few key takeaways for consultants: Understanding compliance: Navigating the complex regulations and avoid costly mistakes. Turning compliance into an advantage: Discover how you as a consultant can leverage compliance as a prospecting tool, saving clients from lawsuits, penalties, and headaches. Embracing the benefits of regulation: Understand the purpose of the CAA and how it exposes bad practices, ultimately improving healthcare for everyone. Join us this week on Self-Funded with Spencer to learn how to not get sued. Chapters: 0:00 - Meet Sarah Borders 6:37 - Sarah’s Journey To Compliance Expertise 14:05 - The Shift Towards Data-Driven Compliance 17:33 - Remote Work As An Entrepreneur 27:01 - Effective Communication = Effective Information 34:57 - Legal Repercussions Of Cobra Compliance 41:34 - Group Health Plan Compliance 46:20 - Yearly Attestation 54:04 - The Impact Of Regulations On Transparency 1:01:21 - Empowering Clients and Consultants 1:04:38 - The Impact Of CAA On Group Health Plans Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #insurance #compliance #industrytrends #ACA #caa #levelfundedplans #Cobra #CobraCompliance #grouphealthplan #ConsolidatedAppropriationsAct #attestation #regulations #consulting #futureofcompliance #healthcarecompliance #selffunded #selffunding #podcast Insurance, Compliance, Industry Trends, ACA, CAA, Cobra, Cobra Compliance, Group Health Plan, Consolidated Appropriations Act, Attestation, Regulations, Consulting, Future Of Compliance, Healthcare Compliance, Self Funded, Self Funding, Podcast

"I think our industry is craving some disruption - and it needs it." - Jack Crotty What does it actually mean to disrupt the health insurance industry?  Jack Crotty, the Director of Business Development of Adyptation, joined me in studio this week for a discussion on the innovative solutions he’s bringing to the consulting world, including pharmaceutical sourcing and specialized disease care that brings incredible care to employees and day one savings to the employers who pay for it.  As Jack says in the episode, Adyptation’s primary goal is to act as a “Robin Hood” figure in the industry, taking the power from the large corporations and giving it back to the people the industry is meant to serve, and anyone who listens to the show knows that’s a mission I can get behind. Jack and I also had a fascinating discussion on what the role of wearables should be in tracking patient progress. When utilized correctly, wearable data allows physicians to assess patient progress as they work towards their personal health goals.  Join us this week for a very future-focused episode of Self-Funded with Spencer. Chapters: 0:00 - Meet Jack Crotty 06:46 - Navigating Approval Processes 10:23 - The Power of Being a Startup Disruptor 18:43 - Specialty Disease Management and Cost Containment 23:11 - Saving Employers 30% Through Sourcing 30:19 - Tracking Health with Wearable Devices 35:32 - Streamlining Employer Benefits with Pass-Through PBMs 37:07 - Strategic PBM Partnerships for Seamless Growth Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #InnovativeSolutions #InsuranceConsulting #Disruption #Disrupters #Startups #SpecialtyDiseases #PharmaceuticalSourcing #ClinicalSupport #AlignedIncentives #Diet #Wearables #SelfFunded #SelfFunding #Podcast Innovative Solutions, Insurance Consulting, Disruption, Disrupters, Startups, Specialty Diseases, Pharmaceutical Sourcing, Clinical Support, Aligned Incentives, Diet, Wearables, Self Funded, Self Funding, Podcast

"There's no reason you can't make content.There's no excuses. Just get started. Because it could open opportunities you don't even know." - Jake Rushton Jake and I can both honestly say that we would not be where we are in our careers today without social media, but for many of those who tune into the show, getting started with producing content can be super intimidating. How do you film reels or podcasts? Do you need a bunch of super expensive equipment right away? And, if you put the time/money in, what’s truly the ROI? Jake Rushton is a 401k and retirement planner who in recent years has also started social media strategy consulting through his company Zeke Digital. He’s mastered the art of starting a social media presence, creating content catered to your goals, and turning your likes and followers into clients.  Of course, in the social media world, ROI isn’t immediate; social marketing is a marathon, not a sprint. But, if you invest your time and energy wisely, you can open up opportunities in your career you’ve never even thought of.  Chapters: (00:06:01) Running A Marathon At Twelve (!) (00:12:54) Managing 401(k)s (00:21:31) The Transformative Potential of Content Creation (00:29:33) Building Trust In You And Your Brand (00:32:30) Overcoming Insecurity and Embracing Imperfection (00:40:01) Efficient Video Production and Distribution Strategy (00:45:40) The Power of Tailored Content on Social Media (00:51:07) Optimizing Your LinkedIn Profile for Success (00:59:01) Leveraging Content Creation for Effective Communication Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #contentcreation #trustbuilding #marathonrunning #crosscountryrunning #401k #digitalmarketing #batchcontentcreation #linkedInprofile #selffunded #selffunding #podcast Content Creation, Trust Building, Marathon Running, Cross Country Running, 401k, Digital Marketing, Batch Content Creation, LinkedIn Profile, Self Funded, Self Funding, Podcast

“I think we're now at a point where we as a society are recognizing we can't wait until it gets bad enough. And how do we get people into care sooner?" - Megan Rozanski I wanted to close out January with a focus on mental health and how to continue breaking down the stigma surrounding it, and Megan Rozanski was gracious enough to join me in the studio to do just that.  Expanding access to and improving the delivery of healthcare have been two key values of the podcast since the beginning, and those objectives are no less important in the mental health sphere.  How did COVID impact the future of mental health care? What pushed Megan to leave her corporate career and take on the uncertainties and challenges of founding a startup in the industry? And what can we do to improve access to care?  Join us to learn the answers to all of those questions and more, this week on the Self Funded podcast! A few of Megan's sources: Increased comorbidities and total cost of care: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Integrated-Care/Milliman-Report-Economic-Impact-Integrated-Implications-Psychiatry.pdf Share of employees in poor mental health who couldn't get into treatment: https://www.kff.org/private-insurance/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/ Increased likelihood of going out of network to see a behavioral health provider versus primary care: https://www.milliman.com/en/insight/addiction-and-mental-health-vs-physical-health-widening-disparities-in-network-use-and-p Chapters: (00:01:41) The Entrepreneurial Journey in a Mental Health Startup (00:09:41) Supportive Work Environments for Mental Health (00:14:22) Revolutionizing Therapist Matching (00:20:56) Personalized Therapy Matching Algorithm (00:29:45) Reducing Barriers and Expanding Access to Mental Health Care (00:35:52) Improving Mental Health Care for Self-Funded Employers (00:49:12) Underserved mid-sized employers seeking mental health access Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #mentalhealth #startup #founder #accessibility #therapy #selfcare #workplacewellness #destigmatize #employeewellbeing #healthtech #HealthcareIndustry #SelfFunding #SelfFunded #Podcast Mental Health, Startup, Founder, Accessibility, Therapy, Self Care, Workplace Wellness, Destigmatize, Employee Wellbeing, Health Tech, Healthcare Industry, Self Funding, Self Funded, Podcast

"Whereas the current structure pits [employers, doctors, and patients] against each other, with Direct Primary Care, we all want the same thing." - Dr. David Cameron For Dr. David Cameron, DPC (direct primary care) isn't just another health insurance acronym; it’s a revolutionary approach to delivering healthcare that has transformed his role as a physician. Beyond incorporating DPC into his practice, David, in his capacity as the Chief Medical Officer at Hint Connect, is actively working to expand the reach of direct primary care to as many practices as possible. His mission is clear: aligning the interests of employers, patients, and doctors for a more cohesive healthcare system. I had the pleasure of speaking with David to gain some insight into the physician's perspective on direct primary care; how it’s not just more cost-effective, but also an efficient and convenient way to provide healthcare. Join us on this DPC-themed episode of Self Funded for an enlightening conversation about the future of healthcare—you won't want to miss it. Chapters: (00:04:19) Personalized Healthcare for Longevity and Well-being (00:14:12) Membership-based Primary Care with Unlimited Access (00:26:25) Decrease in HIV and Tuberculosis Cases (00:33:09) Streamlining Onboarding and Ensuring DPC Success (00:42:41) Text-Based Communication in Direct Primary Care (00:47:10) Comprehensive and Convenient Healthcare Services (00:55:10) Challenges and Opportunities in Direct Primary Care (00:58:33) Streamlining Onboarding for Physicians Starting DPC Practices (01:00:56) The Surge of Direct Primary Care (01:07:08) Transformation of healthcare through direct primary care Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  #directprimarycare #healthcare #costeffective #accessibility #selffunding #physician #primarycare #transformation #healthylifestyle #healthcareindustry Direct Primary Care, Healthcare, Cost Effective, Accessibility, Physician, Primary Care, Transformation, Healthy Lifestyle, Healthcare Industry, Self Funding, Self Funded, Podcast