Dysrupt Healthcare Podcast

Description: In this solo episode, Lester Morales shares his recent travel experiences, uncovering powerful insights from various healthcare markets across the United States. From groundbreaking direct-to-employer strategies in Southern California to employer-driven captive insurance solutions in Napa Valley, and proactive healthcare coalitions in North Carolina, Lester reveals how forward-thinking employers and advisors are reshaping the healthcare landscape.Discover the immense benefits of direct contracting, innovative captive structures, and collaborative approaches to healthcare management. Lester challenges employers and advisors alike to adopt new strategies, prioritize patient care, and reimagine compensation models based on true value delivered.Top 5 Key Moments:02:35 - Transformative Direct-to-Employer Strategies10:50 - How Hospitals and Employers Can Both Win16:20 - The Power of Captive Insurance Programs21:45 - Employers’ Hunger for Healthcare Innovation27:50 - A Challenge for Advisors to Create True ValueListen in to learn actionable strategies and foster meaningful healthcare innovation in your community.Subscribe to the Impact Healthcare Podcast for groundbreaking insights into the future of employer-sponsored healthcare.#HealthcareInnovation #DirectContracting #CaptiveInsurance #HealthcareStrategy #EmployerHealthcare #AdvisorInsights #LesterMorales

In this solo episode of the Impact Healthcare Podcast, Lester Morales tackles the critical conversation around the value of directly connecting healthcare providers and employers. Lester highlights why traditional network-based approaches might not be the most effective way to manage healthcare costs, explaining why closer relationships between employers and hospitals could revolutionize how healthcare costs are controlled, benefiting everyone involved.Discover how employers, employees, and healthcare providers can all win through direct contracting, eliminating unnecessary financial burdens and collection risks. Lester breaks down real-world scenarios to showcase the tangible benefits of bringing healthcare closer to home.📌 Top 5 Key Moments:02:06 - Who Actually Decides Healthcare Prices?05:00 - The Hidden Problem with Healthcare Pricing08:46 - Building Direct Relationships Between Employers and Hospitals10:09 - Real-world Example: Employer and Hospital Collaboration Benefits15:40 - Why More Employers Should Consider Direct ContractingExplore the power of collaboration in healthcare and find out how you can foster meaningful change in your community.👉 Subscribe to the Impact Healthcare Podcast for impactful strategies and valuable insights into innovative healthcare solutions.#HealthcareCosts #DirectContracting #ImpactHealthcarePodcast #EmployeeBenefits #EmployerBenefits #HealthcareInnovation #HealthcareStrategy #LesterMorales

Reference-Based Pricing (RBP) often gets a bad rap, but is it really the healthcare villain many believe it to be? In this Impact Healthcare Podcast recap episode, host Lester Morales dives into the reality of RBP, debunking common myths and clarifying misconceptions about this innovative healthcare pricing strategy.Discover how reference-based pricing, when implemented effectively, can benefit employers, employees, and even healthcare providers. Lester shares insights and real-world stories, illustrating why understanding this approach is crucial for employers looking to lower healthcare costs responsibly.📌 Key Takeaways:How RBP differs fundamentally from traditional PPO programs.Why traditional healthcare pricing methods may incentivize higher costs.The surprising parallels between RBP and existing healthcare payment models.Real-life examples of successful implementations of reference-based pricing.If you're an employer, healthcare professional, or simply someone interested in learning effective ways to reduce healthcare costs, this episode provides essential insights.👉 Subscribe to the Impact Healthcare Podcast for more powerful insights and actionable tips to revolutionize your healthcare strategies.#ReferenceBasedPricing #HealthcareCosts #ImpactHealthcarePodcast #CostManagement #EmployeeBenefits #RBPEducation #HealthcareInnovation #LesterMoralesHere are the 5 most important timestamps from your episode:1:18 - The Problem with How RBP is Currently Viewed2:42 - Why Insurance Companies May Not Want Lower Costs5:06 - How Reference-Based Pricing Works6:40 - Debunking Myths about RBP & Hospital Acceptance9:15 - The Importance of Claims Auditing

In this episode of Impact Healthcare, host Lester Morales dives deep into the world of Reference-Based Pricing (RBP) with Omar Arif, Senior Vice President of Growth at Claim DOC. Together, they explore how RBP is disrupting the health benefits industry by replacing traditional PPO networks with a more transparent, cost-effective approach.Omar shares real-life examples of how organizations can save millions while improving access to care, debunking myths surrounding RBP and addressing common challenges. Whether you’re an employer, benefits consultant, or healthcare professional, this episode provides actionable insights to rethink your healthcare strategy.Key Takeaways:   What is RBP? A simplified breakdown of how RBP determines fair, transparent pricingfor healthcare services.      Overcoming Misconceptions: Tackling fears and addressing the perceived complexity of adopting RBP.        The Role of Advocacy: How proactive communication with providers ensures a seamless transition for employees and minimizes disruptions.      Audit and Fiduciary Responsibility: How Claim DOC’s rigorous auditing process safeguards plan assets andensures fair pricing.      Real-World Success: A case study highlighting a 41.4% reduction in healthcare costs for a 300-employee agricultural company.     Employee-Centric Focus: The importance of lowering employee contributions while improving healthcare access.This episode is a must-listen for anyone seeking innovative solutions to reduce healthcare costs without sacrificing quality.Connect with Claim DOC: Visit claimdoc.com, follow them on LinkedIn, or check out theirpodcast, Claim Talk, available on Spotify and YouTube.Listen now to discover how you can take control of your healthcare costs and create a lasting impact!

On this episode of Impact Healthcare, Lester Morales dives deep into the revolutionary model of Direct Primary Care (DPC) with Dr. Eric Crall, a pioneer in transforming primary care. From the challenges of traditional healthcare to the incredible impact of DPC on employers, employees, and the healthcare system, this episode is packed with actionable insights. Key Takeaways:        What is DPC? A subscription-based healthcare model that eliminates insurance reimbursement and focuses on patient care.      The Employer Advantage: Learn how businesses like car dealerships and restaurants have reduced healthcare costs by up to 25% while improving employee satisfaction.      Why Employees Love It: No more waiting rooms, rushed visits, or financial barriers—DPC provides personalized care with unlimited access to doctors.      Lifestyle Medicine at the Core: Dr. Kroll explains how addressing root causes like stress, sleep, and nutrition prevents chronic diseases and improves overall well-being.    How DPC Scales: Whether your employees are spread across states or constantly on the go, discover how DPC ensures seamless, high-quality care. Real-Life Impact: Dr. Crall shares success stories, including a car dealership that saw substantial cost savings while offering better benefits. Employees gained access to care without out-of-pocket expenses, creating a healthier and more engaged workforce. Who Should Watch? This Episode?      Employers looking to cut healthcare costs and attract/retain top talent. Advisors seeking innovative ways to optimize health plans. Employees curious about how DPC can revolutionize their healthcare experience. What You’ll Learn:       The pitfalls of traditional fee-for-service models.      Why DPC is the future of primary care.         How employers can implement this model to benefit everyone involved. Take Action Now: If you're ready to explore DPC for your organization or want to connect with Dr. Aaron Kroll, visit Subscribe for More: Stay ahead of the curve with the latest strategies to disrupt the health benefits industry. Hit like, share, and subscribe to Impact Healthcare today!

In this episode of Impact Healthcare, host Lester Morales welcomes Josh Butler, President of Butler Benefits and Consulting and High Plains Health Plan, to discuss the game-changing Texas House Bill 711—the "Tier and Steer Bill." This new legislation allows self-funded employers to customize health plans and incentivize employees to choose high-quality, lower-cost providers through financial benefits like $0 deductibles and co-pays. Josh shares how High Plains Health Plan has pioneered this approach, proving that transparent, direct contracting reduces costs while improving care quality. What is HB 711? Texas is leading the way by legally recognizing tiered healthcare models that reward smarter healthcare choices. How "Tier and Steer" Works: Employees pay less (or nothing) when they choose high-quality, cost-effective providers in Tier 1 networks. The Big Insurance Companies’ Role: Why traditional carriers don’t fully adopt these models—premium equals revenue. Direct Contracting Advantage: How negotiating with hospitals directly results in better deals, without hidden network fees. Employer Action Steps: Start with a risk assessment, analyze your claims data, and shift to cost-effective healthcare solutions. Bottom Line: If you’re still managing healthcare benefits the old way, you’re missing out on significant savings and better employee outcomes. Subscribe now for actionable strategies that lower costs and impact healthcare for the better!

In this episode of Impact Healthcare, host Lester Morales sits down with Phillip Holowka, COO of Complete Captive Management Services, to dive deep into the world of captive insurance. Together, they explore how captives empower employers to take control of their healthcare expenses, build equity, and improve employee benefits. Phillip shares his journey from EMS to the insurance industry, offering insights into why captives are a game-changer for businesses of all sizes. Whether you're a seasoned CFO or new to the concept, this episode provides a clear roadmap to understanding captives and their potential for revolutionizing your healthcare strategy. Key Takeaways:       Captive Insurance 101: Understand the difference between group captives, single-parent captives, and traditional insurance models. Control and Ownership: Learn why owning a captive puts you in charge of your healthcare dollars and policy language.        Risk Mitigation: Discover the importance of identifying and addressing high-cost claims to drive long-term savings.         Real-World Examples: Hear how employers, big and small, have leveraged captives to generate underwriting profits and reduce expenses.   Employee Impact: Learn how captives can align incentives, improve transparency, and enhance employee satisfaction. Actionable Insights: Captive insurance is more than a financial strateg it’s a commitment to proactive risk management and long-term savings. Connect with Phillip Holowka: Visit completecaptive.com or connect with him on LinkedIn to explore if a captive is the right solution for your organization. Subscribe now and join the movement to disrupt the health benefits industry with innovative strategies and actionable insights!

🔥 New Episode Alert! 🔥 In this episode of Impact Healthcare, Lester J. Morales sits down with the incredible Jessica Brooks Woods, CEO of the National Association of Benefits and Insurance Professionals. 🏥 Jessica shares her wealth of experience in the healthcare benefits industry, discussing the cutting-edge strategies that are helping employers lower healthcare costs by over 20% while boosting care quality for employees and their families. 💡 🎧 Key Takeaways: Why healthcare costs are skyrocketing 📊 The role of employer-led healthcare coalitions 🛠️ How you can transform healthcare purchasing for better results 💪 🚀 If you're an employer or in the healthcare industry, this episode is a MUST LISTEN! Discover how Jessica's leadership is driving innovation and changing the game for healthcare benefits. 🎯 👉 Don’t forget to subscribe to Impact Healthcare and stay up-to-date with the latest insights on cutting healthcare costs and improving employee wellness! 💥 #HealthcareCostReduction #EmployeeBenefits #HealthcareInnovation #JessicaBrooksWoods #ImpactHealthcarePodcast #LesterMorales

Daniel McCauley, founder of Mac Consulting Group, shares his journey from aerospace engineering to revolutionizing healthcare benefits. He reveals how direct contracting can slash costs while enhancing care quality. Daniel also discusses the flaws in traditional deductible models and shares a poignant personal story motivating his mission. The conversation highlights frustrations with the current system and how straightforward data and innovative solutions can empower employers, employees, and providers alike to challenge the status quo.

In this episode of Impact Healthcare, Lester Morales sits down with Hugh O'Toole, CEO of Innovu, to discuss how data analytics and transparency are reshaping the healthcare benefits industry. Together, they dive into practical strategies that can help employers, advisors, and fiduciaries make smarter decisions, reduce costs, and improve healthcare outcomes. Hugh shares his journey into the benefits space, from managing school consortiums to optimizing healthcare costs through data-driven solutions. He explains how transparency and fiduciary responsibility empower businesses to lower healthcare expenses without sacrificing quality. Learn how small changes, like J-code analysis, can save millions and improve the lives of employees and their families. Key Takeaways: The importance of owning and utilizing healthcare data How fiduciary duty can protect employers and improve employee benefits Real-life examples of cost savings in healthcare and pharma Don't miss out on this insightful conversation that provides actionable steps to reduce your healthcare spend by 20% through total transparency. Subscribe to Impact Healthcare on iTunes, Spotify, or your favorite podcast platform.