Americans pay the highest health care costs in the world and it only continues to increase, year after year. Our guest today is Douglas Aldeen, a healthcare attorney who’s been practicing for more than 20 years.
In a survey done by Policygenius, only 4% of Americans could correctly define the four healthcare terms that explain how much you personally pay for services and drugs on your insurance plan.
And when a majority of employers rely on “industry experts” to help them make decisions...
Now more than ever, Americans are dealing with a variety of chronic diseases which are requiring an unprecedented level of healthcare. In this episode, I sit down with Suzanne Shugg, CEO and Co-founder of Teleplus Healthcare to discuss how her team is changing the way that providers and their teams manage chronic diseases.
Leadership is often lacking today in the business world because leaders are using outdated processes.
They rely on old-school methods of leadership that haven’t kept up with the evolution of society.
But truly transformational leaders have high emotional intelligence. They help coach their teams. They understand that leadership is a skill that you can develop, and they take intentional steps to improve their skills!
As a executive and life coach, Siona Henderson has worked at both small...
There is still a stigma surrounding mental health.
Americans are quick to dismiss and slow to empathize with those who have mental health struggles.
But the reality is that many more of us will deal with a similar struggle at some point in our life than we realize. Matt Marek is the CEO of Good Neighbor Community Services. Matt has spent his career erasing this stereotype and getting people the help they need. From in-home care to corporate environments, Matt’s company helps those who need...
Are healthcare costs stealing the American dream?
According to today’s interview with ScriptSourcing CEO Gary Becker, they are.
Though historically benefits have provided employers a means of attracting and retaining employees, now healthcare costs alone are second only in expense to payroll. And costs continue to rise.
The onset of industries like Medical Tourism and growing disruption by companies like ScriptSourcing, are not only helping employers mitigate their expenses relative to...
Employers want the workforce to be as healthy as possible—but health doesn’t always seem like something the American healthcare system is set up to provide.
We recently interviewed Paige Cooke, Assistant Director of Customer Engagement at NCQA (National Committee for Quality Assurance) in Washington D.C., about healthcare delivery and finance—and how employers can navigate this intricate system.
Everyone is using a different definition of quality, and nobody is communicating about how to...
We know more now than we ever have about what makes us healthy. Why then do healthcare costs continue to rise?
Today we interview Rick Gonzalez from CommuniCare about the evolution of healthcare and the obstacles and solutions facing stakeholders.
When it comes to our health, Rick knows that prevention and engagement are two of the most effective means to driving down costs and keeping patients well.
The challenge is ensuring that prevention and engagement are aligned with what we know...
How does healthcare payment methodology work in light of the four stakeholders of healthcare finance? How can self-funded employers make the art and science of medicine valuable for themselves and their employees?
We recently interviewed Peter Gallitano, a healthcare executive with an academic background in pre-med and finance and professional experience in the clinical, financial, operative, and tactical components of medical providers.
With regard to gaining value in healthcare, Peter...
Is there a way to save money from insurance? Will taking a risk end up saving money in the long run?
Today we interview Don McCully from Medical Captive Underwriters, and he has a goal to have captive underwriting be as transparent as possible.
When it comes to captive underwriting, Don knows that there are risks that need to be measured out when proposing new plans, and sometimes they are risks that employers don’t want to take.
That is, until they realize the potential of what they...
We’re all just asking for a little respect.
We all have different backgrounds, cultures, income-levels, and experiences. Our co-workers, bosses, and customers all have different ways of seeing the world than we do.
Those differences can divide us and make it harder to work together, or they can be a reminder to treat each other with the same respect we want to receive.
That’s why cross-cultural sensitivity in the workplace is and always will be important.
In this episode, Lisa DeRoche,...
If your healthcare provider got a report card, what would it say?
Beatriz Coningham from the National Committee on Quality Assurance has the information at her fingertips, but do the decision makers in your Human Resources department?
In this episode we interview Beatriz, who is the NCQA’s Assistant Vice President of Human Resources.
Primary care physicians have a time deficit. Rising overhead costs due to the reimbursement system force physicians to take on too many patients.
On top of that, unhealthy lifestyles cause massive health concerns that primary care physicians don’t have the time to address.
So the problem is pretty obvious, but how do we fix it?
How do we give primary care physicians the time required to properly treat patients and positively contribute to a higher quality of life while also mitigating...
Once upon a time, primary care physicians handled all but the most perplexing specialized cases.
Those were the days in which a doctor wasn’t running from room to room for 12-minute (or less) visits. They had the time to actively listen to patient concerns and the familiarity with the patient history to handle the cases without referring to a specialist.
It’s hard to find that type of relationship today due to the way that healthcare has changed.
The burden of rising overhead costs and...
If you’re an employer struggling with this idea of improving retention and reducing turnover, you're not alone.
You need to solve the retention puzzle, ASAP.
You need to hear from Todd Tangeman, the Chief Operating Officer and Chief Human Resources Officer for Newton Medical Center.
Retention represents a lot of value. “There are costs associated with hiring and training and onboarding folks,” Tangeman said. “There’s a cost when good members leave.”
Everybody in the healthcare continuum should care about AMPS. Because reference-based payment is the future, that’s why.
Today’s episode of Healthcare Simplified features John Glascott, Chief Revenue Officer of Advanced Medical Pricing Solutions (AMPS), which offers medical bill review.
“We have something we call clinical only medical reviews that review overcharges mistakes—what we call fat finger—a charge that was $710 entered as $71,000,” Glascott said.
Find a breakdown of this episode...
Let’s get the bad news over with first. The number of people who die from hospital mistakes could be as high as 400,000 per year.
On today’s episode of Healthcare Simplified, Tyler Willse interviews Leah Binder, President and CEO of the Leapfrog Group. She specializes in helping employers use their leverage to get safer and higher quality care for their employees.
“When they looked at their own covered lives, they were stunned to realize that they were potentially losing an employee every...
Wouldn’t it be great to walk into a doctor’s office and have them tell you exactly how much a procedure is going to cost?
Mechanics do it. Contractors do it. Even veterinarians do it.
But, for the most part, doctors don’t. Or, it might be more accurate to say, they can’t. Our healthcare system just doesn’t work that way.
In this episode, Karl Ahlrichs, with Gregory and Appel Insurance , breaks down what reference-based pricing is, and how it can help limit post-doctor visit sticker...
It shouldn’t surprise anyone that daily decisions and lifestyle choices affect health. The next step, of course, is that these decisions in turn affect healthcare costs.
The main issue in combating prevalent problems like obesity and prescription costs has been figuring out how to quantify how an individual’s choices cost. The rise of wearable technology and wellness apps are beginning to solve this problem.
In this episode, Jim Campbell, President and CEO of BWell, gives some insight into...
On today’s episode of Healthcare Simplified, Geb Buchness, Senior Vice President of Business Development at Armada Health, is here to say that overlooking referrals specialists is a huge mistake.
“One of the biggest pain points in healthcare is the breakdown between primary care and specialty care—when a member gets a diagnosis and needs a specialist,” Buchness said.
Everybody wins when you use advice to achieve quality outcomes and to find good specialty care.
So, you bought some milk online for $15 a gallon, only to go to the store and see that you could have spent $4. Believe it or not, this happens in healthcare all the time. (But with drugs, not milk.)
That’s why we’re here talking to Kathy Campagna, Vice President Business Development and Director of Specialty Drug Strategy at Magellan Rx, which has a site of service program to help you save money without a lot of member disruption.
She has worked for the last 10 years in the medical...