Dysrupt Healthcare Podcast

In this episode of the Dysrupt Healthcare Podcast, host Lester J. Morales sits down with Heath Potter, Chief Growth Officer and founding member of Six Degrees Health, one of the leading innovators in reference-based pricing (RBP) and transparent cost-containment solutions.Heath shares how a personal family tragedy—his father’s life-changing injury—became the spark behind his mission to make healthcare affordable, transparent, and fair for every patient and employer.Together, Lester and Heath unpack how Six Degrees Health uses data, analytics, and negotiation—not litigation—to redefine RBP, allowing employers to save an average of 30–40 % on medical claim spend while improving member experience and access to care.From the evolution of RBP 1.0 to today’s member-first model, this episode explores:Why most employers are still overspending on healthcareThe myths about balance billing and access issuesHow transparency and independent negotiation build trust between plans and providersReal case studies where employers saved millions without sacrificing careIf you’re a self-funded employer, benefits advisor, or HR leader who’s ready to rethink healthcare costs, this conversation will show you what true disruption looks like.Dysrupt Healthcare Podcast (yes—with a Y) is where Lester J. Morales talks with leaders who are challenging the status quo of American healthcare.Each episode digs into the WHY—the purpose behind the movement—to make healthcare more transparent, affordable, and human.Timestamps00:00 – “This podcast has been disrupted”00:07 – Welcome to Dysrupt Healthcare: Why the Y matters00:52 – Meet Heath Potter, Chief Growth Officer at Six Degrees Health03:02 – The personal story that ignited a mission to fix healthcare04:26 – How transparent pricing helps families and employers05:36 – Real impact: saving $12 million for a client plan06:43 – A physical therapy story that proved the model works08:28 – Reference-Based Pricing (RBP) explained in simple terms10:56 – Lester’s $90K knee surgery example vs. RBP pricing13:34 – Why hospitals accept fair RBP rates15:40 – RBP 1.0 vs. the Six Degrees model: what’s changed18:21 – Data and analytics as the core of modern RBP21:10 – The real stats: 99 % claim acceptance rate first pass24:00 – How negotiations resolve balance bills without litigation26:10 – The next frontier of RBP: member access to care28:02 – Open access plans and real family examples31:00 – Average employer savings of 25–40 %32:54 – Sustainability and flattening the renewal curve34:50 – Case studies: firefighters, manufacturers, and local communities37:13 – Where to learn more and get a free savings analysis39:21 – Final message to employers: “These are real dollars, not smoke and mirrors”Connect with the GuestsGuest: Heath Potter – Chief Growth Officer, Six Degrees Health📧 Heath.Potter@6degreeshealth.com🔗 LinkedIn: Heath PotterHost: Lester J. MoralesFollow on LinkedIn, YouTube & Spotify for more conversations that #Dysrupt the status quo.

Welcome to the first guest episode of the newly rebranded Dysrupt Healthcare Podcast, hosted by Lester J. Morales.Formerly known as Impact Healthcare, this show has evolved with a clear mission to remember the WHY behind disrupting healthcare.In this episode, Lester sits down with Kimberly Carlson, CEO and founder of US Beacon, a company transforming how medical billing integrity is handled in America. Kimberly shares her powerful story — from advocating for her husband during his battle with stage IV cancer to building a company that helps employers and patients uncover costly billing errors that most people never even notice.They expose shocking facts about the system — like why over 90% of medical bills contain errors, how self-funded employers can save millions, and why independent claim reviews are the hidden key to fixing a broken healthcare system.Whether you're an employer, advisor, or healthcare professional, this episode will change how you see medical billing, fiduciary responsibility, and the real cost of care in America.🔹 Learn how to protect your organization from overpayments🔹 Discover what “Disrupt with a Y” really means🔹 Get practical insights from real case studies saving millionsHosted by Lester J. Morales, Dysrupt Healthcare (yes, spelled with a “Y” on purpose) highlights the WHY behind fixing a broken system. Each episode shares stories of leaders, innovators, and disruptors making healthcare more human, transparent, and affordable.00:00 – Attention: This podcast has been disrupted00:10 – From Impact Healthcare to Dysrupt Healthcare: the WHY behind the rebrand00:46 – Meet Kimberly Carlson, CEO of US Beacon03:04 – The personal story that started US Beacon03:48 – 99% of medical claims have errors — why it happens06:14 – Understanding medical coding and billing complexity08:16 – The mechanic analogy: bundling vs. unbundling in healthcare10:30 – Patients’ right to request an itemized bill12:20 – Why every consumer should care about billing errors13:43 – How billing errors drive up premiums14:43 – Real-world example: $12,000 a night for a semi-private room15:43 – Self-insured vs. fully insured: who’s responsible?17:17 – Fiduciary risk and why employers should audit claims18:20 – $5.5 million in savings: real case results20:16 – “Fox guarding the henhouse”: when carriers audit themselves21:44 – Why independent audits matter22:45 – Contracts, RFPs, and clauses that protect employers26:00 – Billing under CMS guidelines and avoiding illegal charges28:10 – How one surgery led to $70,000 in avoidable costs30:13 – Healthcare billing = buying a car without knowing the price31:38 – City government case study: recovering taxpayer money33:11 – Why you need an independent TPA34:39 – The human side: the system isn’t evil, just broken35:26 – The role of AI and automation in claims integrity36:45 – US Beacon’s 1% appeal rate and what makes them different37:00 – The meaning behind “US Beacon” and being a light in darkness37:41 – Final thoughts and call to actionGuest: Kimberly Carlson – CEO, US BeaconLinkedIn: Kimberly CarlsonHost: Lester J. MoralesFollow on LinkedIn, YouTube, and Spotify for more stories that disrupt the status quo.🧠 About Dysrupt Healthcare Podcast🕒 Timestamps🔗 Connect with the Guests

In this inaugural episode of the Dysrupt Healthcare Podcast, Lester J. Morales opens up about rebuilding not just the podcast, but the entire company and mission behind it. After years of leading Impact Healthcare Podcast, Lester realized that the vision had outgrown the name. “Impact” was never the limit it was just the beginning.The new Dysrupt Healthcare Podcast was born with purpose: to go deeper, to reach farther, and to create real change in how we see and experience healthcare. This isn’t just a new season it’s a reawakening of a movement.Lester shares what this transformation means, personally and professionally from redefining his company’s purpose to reimagining how conversations in healthcare should sound. The new format will bring you closer to the real stories, the emotional journeys, and the case studies of leaders who are dysrupting the system for good.This episode sets the tone for what’s to come: honest dialogue, bold ideas, and stories that remind us that healthcare isn’t just about numbers it’s about people.The movement continues louder, deeper, and more human than ever before.

In this powerful solo episode, Lester Morales reflects on the journey of the Impact Healthcare Podcast and shares why it’s time for an evolution. For years, Impact Healthcare has been a platform to highlight innovative ideas, bold strategies, and the leaders willing to push against the broken healthcare system. But as Lester explains, the word “impact” was never big enough to capture the true scale of the movement he and so many others are building.This is not an ending — it’s a transformation. The podcast is entering a new chapter as the Dysrupt Healthcare Podcast. With a sharper focus and a fresh format, this next phase will go deeper into the conversations that matter most: how employers, advisors, and changemakers can dysrupt the status quo, lower costs, and deliver better care for employees and their families.In this transitional episode, Lester shares:Why the shift from “Impact” to “Dysrupt” represents more than just a name change.What listeners can expect from the new content, structure, and tone of the podcast.How the larger movement for healthcare disruption is growing — and why your voice and participation matter now more than ever.This episode isn’t a goodbye. It’s an invitation to continue forward — to be part of the movement, to challenge what’s broken, and to help create a system that truly works for people. The Impact Healthcare Podcast opened the door. The Dysrupt Healthcare Podcast will break it wide open.

What if burnout didn’t have to be the norm?In this powerful episode of The Impact Healthcare Podcast, host Lester Morales dives deep with John Troutman, Vice President of Business Development at Mind Club America, a revolutionary mental health platform built for prevention—not just crisis response.John shares his raw, personal story of burnout, the months-long journey through recovery, and how it became the catalyst for helping others. Together, they expose the flaws of traditional EAPs, debunk the “we’re here when you need us” myth, and offer a clear, proactive solution for employers, advisors, and leaders who want to make mental health truly accessible and impactful.✅ Learn how Mind Club helps organizations reduce turnover, improve productivity, and provide fast access to real mental health professionals✅ Discover the simple 3-minute assessment that sets a new standard for self-awareness and care✅ Explore how leadership buy-in transforms employee engagement with mental wellness tools✅ Understand how stigma, accessibility, and outdated networks are failing today’s workforce—and what to do about itThis isn’t a feel-good conversation—it’s a real conversation with real tools to make mental health a business strategy, not an afterthought.Take the free assessment or learn more: https://mindclubamerica.com🫶 If you know someone silently struggling—or a leader ready to do something different—share this episode. You could save a life.#mentalhealth #burnout #leadership #employeewellbeing #healthcarestrategy #impactpodcast #mindclub

What if you could avoid invasive orthopedic surgery using your own cells?In this eye-opening episode of the Impact Healthcare Podcast, host Lester Morales talks with Dr. Mark Testa—chiropractor, acupuncturist, and Regenexx expert—about the groundbreaking procedures helping thousands of patients skip expensive surgeries and recover faster with regenerative treatments like bone marrow concentrate and PRP (platelet-rich plasma).You’ll learn:How Regenexx helps patients avoid knee, shoulder, and spine surgeriesReal-life patient success stories and outcomesThe massive cost savings and faster return-to-work for employersWhy musculoskeletal issues are a top cost driver in health plansHow self-funded employers are integrating Regenexx into their benefitsWhether you're an advisor, employer, or patient seeking alternatives to surgery, this episode delivers valuable insights into the future of orthopedic care.👉 Learn more: https://regenexxbenefits.com📩 Contact Dr. Mark Testa: mtesta@regenexx.com🔗 Connect with Lester Morales on LinkedIn

In this powerful episode of *Impact Healthcare*, host LesterMorales sits down with a true industry whistleblower  Wendell Potter, former Cigna and Humanaexecutive turned healthcare reform advocate. Wendell pulls back the curtain onhow health insurance really works, exposing the profit-driven machine thatprioritizes stock prices over patient care.From defending high-deductible plans to becoming a fierce critic of them,Wendell shares his personal transformation, his fight for a more transparentand fair system, and why the healthcare system isn’t broken — it’s workingexactly as designed... for Wall Street.🔥 Inside this episode:- What the Medical Loss Ratio (MLR) really means for employers and patients- How health insurers and hospitals maintain a profit-first alliance- The unethical broker-carrier dynamic no one wants to talk about- Why Wendell walked away from a high-paying C-suite role to expose industrycorruption- Real stories of hope and disruption in healthcare happening *right now*Whether you're an employer, advisor, or just someone who’s tired of risingpremiums and shrinking benefits, this is a must-listen.📩 Connect with Wendell: [HealthcareUncovered](https://healthcareuncovered.substack.com)📽️ Watch the documentary: *It’s Not Personal, It’s Just Healthcare*(featuring Wendell)🎧 Don’t forget to subscribe and share this episode if you believe increating a better healthcare system.

In this high-impact solo episode of Impact Healthcare, host Lester Morales recaps the key takeaways from April’s conversations — and it all comes down to one powerful word: strategy.From exploring the costly trap of reactive renewals to redefining how employers, brokers, and hospitals collaborate through direct contracting, Lester challenges the status quo of the healthcare benefits industry. He also revisits his powerful interview with Seppa from Motive, VP of People & Learning, who shares how her organization transitioned from fully insured to self-funded — resulting in improved employee benefits, cost savings, and deeper employee engagement.🔥 You’ll learn:Why most employers operate on a faith-based model with no real healthcare planHow direct-to-employer strategies and captives are reshaping cost controlThe real-life ROI of benefits aligned with the employee lifecycleWhy KPIs in healthcare are dangerously misaligned — and what to do about itHow one company used healthcare savings to expand parental leave and elder careWhether you’re an advisor, HR leader, or employer, this episode delivers the roadmap to move beyond the annual renewal scramble and build a benefits plan that actually works.🔗 Connect with Lester: lester.morales@nextimpactllc.com📬 Got a topic or guest suggestion? We’re listening. Let’s impact healthcare — together.

What if healthcare wasn’t broken—but simply built wrong?In this episode of the Impact Healthcare Podcast, Lester Morales sits down with Rob Andrews, CEO of the Health Transformation Alliance and former U.S. Congressman, to explore how large employers are fixing healthcare—not through policy alone, but through bold action, cultural alignment, and smarter benefits design.Rob shares his personal “why,” rooted in his father’s death and the lessons that continue through his work today. Together, they dive into decades of insights from Rob’s leadership in both government and the private sector, including:The foundational flaws in fee-for-service and the urgent need for value-based careHow self-funded employers are improving outcomes by aligning benefits with talent retentionThe true ROI of investing in navigators, virtual care, and benefit educationWhy personal accountability is key to improving health outcomes—and how incentives must evolveHow major organizations like American Express retain talent through human-first healthcare designCreative strategies like 0 copays for engagement and charitable rewards for smart healthcare choicesFrom policy debates like the MLR rule in the Affordable Care Act to real-world success stories—like a walking club that grew out of a doctor’s concern for her lonely patients—this episode challenges you to rethink what’s possible in employer healthcare.If you’re an employer, advisor, or HR leader ready to:Design benefits that actually improve livesAlign healthcare spend with business and cultural goalsShift from reactive to proactive care modelsCreate long-term impact beyond cost containmentThis episode is a masterclass in how to lead with vision, humanity, and strategy.Listen, take notes, and share this episode with someone who needs to stop waiting for the system to fix itself—and start doing something that works.Keywords:Rob Andrews, Health Transformation Alliance, value-based care, healthcare navigation, self-funded insurance, outcomes-based payment, healthcare cost control, employer healthcare strategy, employee benefits innovation, healthcare incentives, benefits design, personal accountability, primary care, employee retention, impact healthcare podcast, Lester Morales

What if your healthcare benefits did more than check a box—what if they changed lives?In this episode of the Impact Healthcare Podcast, host Lester Morales is joined by Sepa Sete, VP of People + Learning at Mocean, for a candid and practical conversation about how HR can take the lead in creating people-first organizations through intentional benefit design.Sepa shares the journey that led Mocean to move from a traditional fully-insured model to a self-funded healthcare plan that not only reduced costs but dramatically improved the employee experience. She breaks down how her team:Mapped the entire employee lifecycle to align every stage with meaningful supportReimagined healthcare benefits to match their company culture and evolving talent needsAdded family planning coverage after losing key candidates due to outdated benefitsIntroduced virtual healthcare with Galileo to improve access and reduce unnecessary costsExpanded paid parental leave and began building support for employees caring for aging parentsUsed listening and data to guide strategy and improve employee satisfactionThis episode includes powerful real-life stories, including how one benefit decision helped a couple become parents, and how a personalized approach to healthcare made all the difference for a team member battling cancer.If you're an HR professional, benefits advisor, or business leader looking to:Improve talent retention and recruitmentOffer better healthcare without raising costsCreate alignment between company culture and benefitsExplore whether self-funding is right for your organizationThis conversation will challenge the status quo and offer a roadmap to meaningful change.Listen now and subscribe to the Impact Healthcare Podcast for more stories and strategies from leaders redefining the future of employee benefits.