Benefits with Friends - The Rise of the American Healthcare Consumer

Consumerism in healthcare should empower patients to make better medical choices. Instead, it penalizes them with higher hospital prices when making bad decisions and forces them to acquire extremely costly services. Leo Wisniewski, Co-Founder and CIO at Health Cost Labs, does not want such unethical practices to thrive in this space. In this episode, he joins Louis Bernardi to share the mobile application he and his team developed to address the consumerism problem in healthcare: Billy.app. He presents how it can help patients find lowest-cost medical alternatives in the market and confirm that they are not being overcharged, bringing back the buying power to the people. Leo also explains how they aim to disrupt the status quo through this app, turning the insurance industry around for the benefit of healthcare space and giving a competitive edge to independent facilities.

Ironically, this episode aired live on the 4th of May, which is commonly referred to as "May the Force", a play on the iconic line from Star Wars, "May the Force be with you!" Fittingly, we are joined by Allison De Paoli, the Founder of Altiqe Consulting, who is a "Force" in the benefits arena, having received recognition from many industry organizations. Our conversation focuses on actionable data versus numbers. Most health plan sponsors are familiar with numbers, especially at renewal time to support the inevitable premium increases. Unfortunately, far too many aren't familiar with the impactful data that is finally available in abundance. Data can help plan sponsors and their members make informed healthcare decisions rather than blind health insurance decisions usually based on premiums. Tune in to this episode with Allison De Paoli today.

After working as an employed physician in a major hospital system for 8 years, Dr. Jeffrey Gold began to get increasingly frustrated with the bureaucracy of insurance-based medicine that resulted in less of his time spent on caring for his patients in the way he envisioned since he was considering medicine as a career. In 2014, he opened the first independent Direct Primary Care practice in Massachusetts – Gold Direct Care PC. Based in Salem, MA he currently cares for 700 patients and has an Internal Medicine physician partner and recently added a Family NP. He has also formed a side business called the Starseed Group LLC which hopes to have DPC doctors, benefits advisers, TPAs, and self-funded employers collaborate to build employer sponsored plans that have DPC as the “seed” of the plan with direct contracting for all other services. Dr. Gold has been intimately involved in helping other MA primary doctors escape the fee for service world and MA now has approximately 15 independent DPC physicians. He is a co-founder in both the New England DPC Alliance as well as National DPC Alliance. He also is a member of the Direct Primary Coalition. Join this conversation as he shares more of his story and what his advocacy is all about.

Lou will be joined by Korb Matosich, Co-Founder, CEO and Board Member of Asserta Health. Korb has an unusual depth of experience managing all sides of health care payment. He oversaw both Revenue Cycle Management and Payment Integrity businesses at Ingenix, now Optum, at UnitedHealth Group. He also served as the CEO of AAPC, an organization that certifies billers and coders. Asserta Health: Bulit on the foundation that the only way to make healthcare affordable is to pay for it the same way we pay for everything else – direct, transparent, immediate. Asserta Health, has created a real-time cash payment platform, called medEcash, that allows self-funded employers to pay a cash price at the time of service for high-cost medical care for covered members. This payment strategy results in dramatically reduced prices from network rates and saves money for both the employer and the member. It also eliminates the risk balance bills and helps ensure access for needed care. Asserta Health has processed over 40 million dollars across more than 21 thousand transactions using the medEcash platform to service 30,000 employee lives eligible for the cash payment program.

Lou and his guest, Brian Del Savio will discuss the issues employers have addressing the real struggles their employees face such as mental health and affordable access to fundamental healthcare. The benefit strategies (Pay More, Get Less) many employers have been forced to swallow leave many employees struggling to access care when they need it the most. Technology can help address this issue by putting benefits with real-time access to solutions at their employees' fingertips. Brian Del Savio Bio As Vice President of Sales, Brian helps employee benefit advisors develop a clear path to success by enhancing benefit plans with innovative, fully customizable, best in class benefit and technology solutions. Employee benefit advisors have access to 35+ of the most highly vetted non-insured enhanced benefit vendors at discounted wholesale pricing, without having to juggle multiple vendor contracts. Solutions include Virtual Mental Health, Advocacy & Transparency, Virtual Health, Fertility, Health Discounts, Pet Discounts, ID Theft Protection and more. The benefit programs can be branded to the employee benefit firm or even to each employer group. Employees access all benefits in a single membership through a mobile app and member portal, increasing utilization drastically. Before coming to New Benefits, Brian worked in the financial services industry as a financial and health insurance advisor, creating individualized plans to improve financial security for individuals, families, and businesses. In his personal time, Brian enjoys exercising, which usually involves chasing around his 6 year old son and 3 year old daughter on bikes, at the pool or at the beach. Ice Hockey has played a major role in Brian’s life, so you can also catch Brian watching, playing or even officiating hockey as a USA Hockey Referee. Brian has been married to his wife Christy for 9 years and they currently reside in Southwest Florida. New Benefits Bio Pioneers of the non-insured benefits industry for 32+ years. New Benefits has been disrupting the benefits marketplace since 1990 with innovative products, cutting-edge technology, and first-class service. As the leading wholesaler of non-insured benefits, we aggregate the most sought-after healthcare and lifestyle solutions for over 4,000 groups and millions of members. Our clients strengthen their health plans with a customized blend of 30+ non-insured benefits to help members navigate healthcare, find affordable care, reduce stress, and save time — all conveniently packaged in an easily accessible mobile app and web platform. Through regular use of their benefits, our members save millions of dollars annually on healthcare and everyday living expenses, increasing their happiness and productivity at work and home.

Streamlined and automated processes not only help save time and effort but also money. For patients, this means having to save and avoid the unnecessary costs caused by errors and overcharging. Pranov Duggasani and Zoe Holderness founded Slingshot Bills, a company that automates the patient advocacy process and saves individuals and their employers’ money. In this episode, they join Louis Bernardi to tell us what led them to start their company along with the problems and solutions they found in the healthcare system. In particular, they take a deep dive into the value of leveraging technology to help manage healthcare spend. Pranov and Zoe discuss the many issues they encountered while auditing, from bundling issues to EOB errors and more. As consumers, we have the right to information that is so often not given to us. Follow along to this great conversation and learn important insights that could help you pay less for your health care without more work.

For the past three decades, the American healthcare consumer has been the leverage used by insurance carriers and healthcare systems against each other. Which strategies must be implemented to give them back this leverage and simply settle with the lowest plans? Louis Bernardi talks with Chris Hamilton of Hotchkiss Insurance about the best approaches in mending the gap between health insurance and healthcare. They break down how to create an ecosystem that allows employers to give consumers a choice and drastically lower insurance costs. Louis and Chris also talk about the importance of educating employees about getting the right health plan instead of assuming they wouldn’t care about such a complicated matter.

There is probably no aspect of healthcare that has changed as dramatically over the last few years as insurance claims data. For every C-Suite leader or HR manager to justify their next rate increase, they must have the right amount of data at their disposal, gathered from the clients themselves. However, most employers do not have any access to this information. Jacob Sheridan of TPA Stream aims to make this process a lot more convenient through their product, Beacon. Joining Louis Bernardi, he explains how this simplified and standardized process helps collect historical claims data. He discusses how it can help business owners deliver better plans and guide consumers to make better insurance decisions. Jacob also talks about how the right gathering of such data can give back leverage to the people so they can stop being mere spectators.

Lou and Sims Tillirson will discuss the strategies and solutions that forward thinking HR teams are utilizing to keep their employees engaged and connected. HR leaders have to balance the time it takes to engage with members and the time they need to get stuff done. The extent of the remote work force today makes this even more challenging. Technology is great...when it works. So, what works and what doesn't? Who is Sims Tillirson? Sims Tillirson has worked in a variety of leadership positions at Fortune 500 insurance carriers, enrollment firms, and benefits technology firms. He currently serves as Head of Sales for Showcase, an employee engagement and benefits education platform. Outside of the office, he is an avid Community Volunteer, Tattoo Enthusiast, Recording Artist, Multi-Instrumentalist, Singer/Songwriter, and People Connector. He lives in Forest Acres, SC with his wife Brianne, son Jack, and dog Doc. We'd love to share our thoughts with you and hope you'll share yours with us too.

Marshall Allen’s book, "Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win," shows individuals and employers how they can push back against the high cost of health care. It's led to Allen Health Academy, which takes the principles of the book and communicates them through an engaging series of health care literacy videos for consumers. The videos are currently in production. Marshall’s stories have been featured by the New York Times, Washington Post, USA Today, The Today Show and other outlets. Speaking engagements include AcademyHealth, the Association of Health Care Journalists, the Michigan Hospital Association, the National Patient Safety Foundation and Stanford's Medicine-X. Before journalism, Marshall spent five years in full-time ministry, including three years in Nairobi, Kenya. My Master's degree is in Theology. I am currently working as an Assistant Regional Inspector General with the Office of the Inspector General - HHS. Lou and Marshall with share true stories of success including how real patients fought the system and won. Health care and insurance are overly complex by design. Learn what enhancing your IQ can mean for the average American and their employers.

Emma Fox is Partner and COO of E-Powered Benefits. Her firm helps employers throughout the US customize health plans using alternative healthcare models that are capable of significantly enhancing benefits for members while at the same time lowering the cost by 20-40% (or more). The key is increasing awareness and resetting customer expectations through education. The current fee-for-service delivery system ensures a misalignment between plan sponsors/members and all other stakeholders. An informed consumer is capable of breaking status quo results. That's why Emma helped create the Certified Health Value Advisor education module for employers and consultants.

This episode of Benefits with Friends will feature Patrick Moore, President of Axim Fringe Solutions. Patrick is an Emerging Star in the benefits arena nationally who recently retired from the United States Marine Corps. How ironic that he will be appearing on our show on the 247th Birthday of the US Marine Corps...Oorah! AXIM Fringe Solutions Group, LLC (AXIM FSG) is the nation’s first and only health and welfare administration and compliance firm that is also a government contractor. In addition to being a Jarhead, Patrick is also self-proclaimed Geriatric Millennial. We'll find out what that means to him. Lou is very much interested in getting Patrick's perspective on the current state of employer sponsored health plans and the fee-for-service healthcare system. An industry in complete disarray must be quite alarming for someone so used to regime and discipline. What tools does Patrick's past lend to help him help others threw the great unknown?

Our host Lou *BOO* Bernardi and guest Nancy Giacolone discuss the Role of HR Leaders in the Post COVID era.

Lou and his guest Dave Chase discuss the Health Rosetta, high-performance health plans, the Quadruple Aim, and the results when a shift in mindset takes place that takes the attention off the insurance costs and places it on the quality of health care.

Please join me and my guest Dale Sagen Vice President, Group Captive Solutions at Risk & Insurance Strategy Collective (RISC). Dale is responsible for leading and collaborating with benefit advisors and plan sponsors to develop and implement captive strategies for employers’ health & welfare plans. Dale has specialized in the support of successful self-funded health plans with the facilitation of a group captive strategy that is customized for the sponsor and employers. Captives are becoming a more sought-after stop loss solution for employers that wish to self-insure their group health insurance plans. Dale will share his insights with our audience.

Episode 19 of Benefits with Friends was the showdown of the century as the reigning Broker of the Year Josh Butler squared off against his buddy and rival Adam Berkowitz. Our host Lou Bernardi had to keep these two fierce competitors under control as they fought tooth and nail. Adam took off with a sizeable lead, but Josh came back and tied it up. Who won? You'll have to tune in to find out.

What You’ll Learn In This Episode This transcript is machine transcribed by Sonix

My guest Eric Silverman of Voluntary Disruption and I discussed Marketing & Media for the Enrollment Win. Employers desperately need to reengage with employees in the post COVID era. The battle to attract and retain talent is real! DIS-RUP-TION, N. - a radical change in an industry (or) business strategy. "Words are very powerful things that have incredibly intense meaning. By simply changing your verbiage, you're truly able to disrupt the status quo an amazing and unexpected ways." - Eric Silverman Eric is also the host of the hugely successful Rockstars Rocking podcast available on Spotify, Apple and Google Podcasts.

EZaccessMD provides employers and employees alike with what they call the EZ Difference: comprehensive, convenient care that comes right to the doorstep. Their members can consult with a doctor in minutes and receive on-site assessment and diagnostics – all in under 2 hours. For the employee, this means no time spent traveling and sitting in waiting rooms, no money spent on a copay, and no added stress. For the employer, this means money saved on insurance claims, loss of productivity, turnover, and absenteeism.

In recognition of Mental Health Awareness Month, I can't think of a better guest to have on than CEO of Orriant and Founder of Aspirational Healthcare than Darrell Moon. Darrell is passionate about population health, behavioral health and can help employers address this very important topic.