Dysrupt Healthcare Podcast

Lester J. Morales interviews Attorney Julie S. Selesnick, Senior Counsel at Berger Montague. With a passion for justice amongst the imbalance of power between health insurers and American healthcare consumers, Julie serves as a member of the firm's Employee Benefits & ERISA practice group.  Don't miss this opportunity to learn: 3 myths that hamper employers' success as fiduciaries of their health plans  The top 3 action items for employers to jumpstart their fiduciary compliance How to eradicate gag clauses  Julie's top recommendations for employers, advisers, and American healthcare consumers You'll want to share this priceless podcast with your colleagues — be sure to subscribe! Time Stamps: 05:03 Myth 1 07:24 Myth 2 10:00 Myth 3 13:37 No. 1 Employer Action Item to jumpstart your fiduciary compliance 14:49 No. 2 Employer action item to jumpstart your fiduciary compliance 15;18 No. 3 Employer action item to jumpstart your fiduciary compliance 16:17 Julie explains the claims data access lawsuit filed against Anthem 18:04 The skinny on gag clauses 30:43 Julie’s #1 recommendation to employers 36:59 Julie’s #1 recommendation to advisers 41:14 Julie’s #1 recommendation to healthcare consumers Stay connected with cutting-edge health benefits strategies by joining the Impact Healthcare text community at 813.537.6992.

Lester J. Morales talks with Dean Jargo, the chief executive officer of Fair Market Health, about how employers can make healthcare more affordable and accessible.   Get a glimpse behind the scenes as Dean, a former CFO advising Fair Market Health, became its CEO after a personal experience with the marketplace platform transformed his drive and determination to bring affordable healthcare to the masses.   Learn from the experts: Three common self-funded healthcare models employers utilize to manage their health benefits.  Two things Dean wishes he had known earlier in his career The common misconception about cost vs. quality in healthcare How and why incentives pay off big Why big box carriers don’t work harder to make healthcare affordable Affordable and accessible healthcare hinges on the cost vs. quality relationship — buying healthcare isn’t like buying a luxury car. Higher prices don’t equate to better care, and the undercurrent of misaligned incentives can crush forward progress if left unaddressed.  This episode of Impact Healthcare covers all the bases to get your company on the road to higher-quality care for a much lower price.   Time Stamps: 8:59 Fair Market Health: Who are they, and what do they do? 10:43 The 3 health benefits models 15:35 Two things Dean wishes he had known earlier in his career 19:15 The turning point in Dean’s career story 26:00 The common misconception about cost vs. quality in healthcare 27:05 How Fair Market Health pairs patients with providers 35:10 Why incentives matter 37:29 How $0 copays and $0 deductibles pay off big 40:29 Why claims savings don’t mean the doctor gets paid less 42:47 Why don’t the big box carriers work harder to make healthcare affordable? 49:15 How are savings different between urban and rural populations? 50:48 Where you can find the most savings 54:39 What can employers do to take the best next step? Connect with Dean at dean@fairmarkethealth.com www.fairmarkethealth.com Reminder! Stay connected with cutting-edge health benefits strategies by joining the Impact Healthcare text community at 813.537.6992.

Description: One in 3 Americans has pre-diabetes, and over 80% don’t know it. Left unaddressed diabetes is the leading cause of kidney failure. The cost of care is exorbitant, but it can be reigned in through capitated disease management.  Far too many patients wade through life with undetected kidney disease that ultimately demands dialysis seemingly overnight. And as patients advance through the disease stages, the claims just get pricier.  These costly cases raise premiums and out-of-pocket expenses for the affected member and the entire insured population at that organization. Employers can avoid unnecessary spending on chronic kidney disease by up to 80% through capitated disease management that often avoids or delays dialysis altogether. Find out today how personalized, capitated disease management detects the smoke so plan members’ wellness doesn’t burst into flames.  Listen as Lester J. Morales talks with Kimberlee Langford, the Vice President of Clinical Services for Specialty Care Management, to hear how employers and brokers prevent diabetes from igniting the fuse that leads to costly dialysis treatment.  Show Notes: 5:37 Impacting a life saves a significant amount of money. 6:33 Why dialysis is a preventable disease. 10:07 How preventable disease sneaks up on workers. 12:37 Cost of care goes up 57% as patients advance in disease stage. 16:39 How to improve member participation rates to 50-75%. 24:43 The proof is in the pudding: Case #1  26:18 Personal service is life-changing: Case #2 28:21 How to save up to 80% on dialysis claims with a capitated disease management program. 32:26 How to address misaligned incentives in disease management.  36:58 Be a superhero: Case #3 38:51 Nurses have a huge impact on patient outcomes: Case #4 Reminder! Stay connected with cutting-edge health benefits strategies by joining the Impact Healthcare text community at 813.537.6992.

In this episode, Lester J. Morales talks to Aaron Witwer, President of BenEngage, about health equity and how it impacts different communities. We'll discuss ways to innovate, address healthcare disparities, and explore ways to create a more equitable healthcare system.     Show Notes:   Aaron Witwer talks about his background and how he got involved in healthcare (5:00)   Lester and Aaron talk about how we can start a conversation with an employer about health equity to create a change (12:00)   The importance of education impacts different communities. (20:00)   Lester asks Aaron what the keywords and actions are to create health equity (26:00)   Aaron talks about what we need to do to get health equity and address disparities. (29:00)

Description: Benefits cost more and cover less; out-of-pocket costs are skyrocketing. The healthcare system is frustrating. Lester Morales sits down and talks with Reid Rasmussen Co-Founder and CEO of Freshbenies. They discuss how the combination of high costs and poor health outcomes is not a mistake. The system is built wrong and is working as supposed to. But, prioritizing quality healthcare outcomes addresses the core problems in the healthcare system and achieves lower costs as a positive consequence.   Show Notes:   Reid talks about why and discuss the healthcare system is getting more complicated and how difficult it is to be a patient (01:25)   Lester and Reid discuss the importance of Advocacy and how the wave of new ideas must be included. (13:23)     Reid infantizes the lack of quality information and how the system continues without us as a society. (18:00)   Lester and his guess Reid talk about how they need to strive to create an impact using more tools and how they must keep talking about approaching healthcare differently. (41:00)

Episode Description: Employee retention is central to the success of a business. We know that employers are aware of this, and it’s a key priority to reduce the number of employees leaving their roles. But employee retention strategy falls short unless you take a truly inclusive approach. Lester Morales chats with Brandon Weber, Co-Founder & CEO NAVA Benefits, a modern brokerage that makes managing benefits easy for growing businesses. They discuss different ways to break the status quo and the traditional brokers system and how diversity is part of a greater impact. To keep up with the latest innovations and innovators changing the health benefits world, please subscribe to the Impact Healthcarepodcast. o become part of the Impact Healthcare Community, please text "IMPACT HEALTHCARE" to 813-537-6992.   Episode Show Notes:   Bradon introduces himself and his purpose for entering the health benefits space (1:55). Brandon explains how healthcare felt unsafe in his family environment (4:00). Lester and Brandon chat about process automation, so you focus on things that matter more (17:00). They discuss recruitment strategies and how diversity is a critical component that makes a business successful in healthcare and technology (33:00).

Episode Description:  On this episode, Lester chats with Ed Ligonde, Executive Vice President of Nielson Benefits Group, live from Coral Gables, Florida.  Given his 14 years of experience as a benefits advisor, Ed gives a diverse view of the health benefits industry and details a few personal experiences that have shaped his advisor's perspective. He also shares tips with advisors and employers to serve employees better.   Episode Notes: Ed introduces himself and his purpose for entering the health benefits space (1:20).  Lester touches on diversity in health benefits and asks Ed to share some tips for diverse youth looking to enter the industry (4:00).  Ed tells a story about his mother (7:28) and how he helped save her life by transforming how he approached healthcare (16:02).  He also shares another story about employee health benefits that most resonates with him (23:15). Lester asks Ed to share advice with employers (25:30) and advisors (28:22).

Description:  On this episode, Lester sits down LIVE with Spencer Smith, host and creator of the Self-Funded with Spencer podcast, to discuss the value of self-funding and why all organizations should be taking steps to gain control of their employee health benefits.  Together, they touch on topics such as the importance of data, having honest conversations about compliance, and myths associated with self-funding. Spencer also presents a handful of stories highlighting clients that reaped the benefits of this strategy. Show Notes:  Spencer starts off by introducing himself and his various professional endeavors (1:03).  Lester asks Spencer to explain the value of self-funded insurance plans (3:40) and why employers and advisors tend to shy away from this strategy (6:50).  Spencer lays out the perfect time for an employer to start thinking about self-funding (8:39) and myths associated with the practice (9:33).  The two talk about the importance of data access, why employers aren’t using it today, and common use cases for data (11:00).  Spencer also discusses the importance of compliance conversations (16:45) and the difference between big and small employers (19:20).  He lays out a failure and success story from his time working with self-funded plans and companies (25:00).  Lastly, Spencer leaves the audience with an actionable case study from one of his clients who implemented a self-funded employee benefits plan (33:00).

Lester Morales dedicated this episode to his beloved mother, Maria Morales. After medical bills devastated his family with the financial ruin of bankruptcy at age 17 and losing both his parents to cancer, Lester is fueled by a very strong WHY.  Lester saw the misalignment and started a new path led by a passion and change. This episode will ask critical questions for navigating healthcare and focus on attending the number one asset of every employer's by showing the pathway to a better healthcare. Let's ALWAYS SHOW LOVE by bringing better quality care at the lowest cost. To keep up with the latest innovations and innovators changing the health benefits world, please subscribe to the Impact Healthcare podcast. o become part of the Impact Healthcare Community, please text "IMPACT HEALTHCARE" to 813-537-6992.

Description:  On this episode, Lester is joined by Ziad Rubaie, Chief Business Development Office at Consociate Healthcare, for an honest conversation about the importance of aligning directly with providers.  Ziad gives helpful tips on how employers can cut out the middle man (insurance carriers) and turn healthcare into a performing asset rather than an expense. He also expounds upon these strategies with real, personified success stories from his time in the industry. Show Notes:  Ziad starts the podcast by introducing himself and his company. (1:21)  The pair discuss consumerism in healthcare. (16:34)  Lester emphasizes the importance of staying active when it comes to employee health (20:19).  Ziad breaks down the term “directing traffic” in employee health benefits (22:04) and describes the three different types of providers (24:40).  He then discusses the financial results and the improvement of the member experience (30:15).  Lester asks Ziad why all employers aren’t implementing these strategies (32:08) and get him to tell a case study from one of his clients (36:02).