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This episode features an interview with Lee Lewis, Chief Strategy Officer and General Manager of Medical Solutions for Health Transformation Alliance (HTA). At HTA, he spearheads efforts across 50 large employers and six million employees to transform healthcare, save lives, and save millions of dollars. Lee has spent his career advising Fortune 10 employers, insurance companies, medical associations, and the Departments of Justice and Labor.
In this episode, Sasha sits down with Lee to discuss the benefits of a TPA versus an ASO, virtual primary care, and putting trust back into healthcare.
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“If you are a huge employer, if you’re AT&T or Walmart, you have enough leverage that carriers will build systems in place that enable you to do creative things. The difference between a TPA and a carrier is, it's still remarkable but it's smaller. The gap is smaller. But, if you're a small employer, you don't have the buying power with any carrier anywhere. You're a rounding error to them. You're not going to get any type of flexibility or creativity supported. Whereas, if you work with an independent TPA, you can still access a lot of those things that might otherwise only be accessible for a huge employer. Secondly, getting data is really hard with large carriers. If you have a TPA, you have the chance to get your data like a large employer might, even though you're smaller.” – Lee Lewis
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Episode Timestamps:
*(01:09): Lee breaks down TPA versus major carrier options
*(04:53): Busting the myth that TPA is more complicated than ASO
*(10:39): The top 3 components of a best-in-class healthcare benefits program
*(22:05): Lee’s opinion on virtual primary care
*(28:27): Lee discusses self-funded versus fully insured
*(33:17): Lee shares his favorite healthcare story
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Links:
Listen to Broken Benefits Podcast