Dysrupt Healthcare Podcast

Description: On this episode of Impact Healthcare, Lester is joined by Bill Miller, CEO of Drexi. Together, they discuss the intricacies of the pharmacy benefits industry and how Bill transitioned from a serial entrepreneur to an honest, transparent PBM. In the episode, he breaks down a real-life example of claims data and shares powerful analogies to help listeners understand the difference between transparent pharmacy benefits and traditional pharmacy benefits. Bill also shares several words of advice for employers and advisors when choosing PBMs. Show Notes: Welcome to Impact Healthcare! Bill kicks the podcast off the podcast by describing how he got into the industry as an ‘honest’ Pharmacy Benefits Manager (PBM) (1:00) and describes how a traditional PBM operates (4:00). He also explains how this affects fully insured employers (14:55) and how PBM’s are compensated under a self-insured model (17:20). Bill shares a real-life example of claims data and breaks it down (20:45) and why employers shouldn’t chase rebates (33:00). Lastly, Bill shares advice and questions that, if answered incorrectly by a PBM, should raise red flags for any employer or advisor (40:15).

Description: Sovereign Health Advantages: Impacting the health benefits offering for Tribal Groups and their business entities. On this episode of Impact Healthcare, Lester sits down with Cameron Cummins, Managing Partner at Transparent by Design. Together, the pair discuss his experience working primarily with tribal entities and discusses how he’s able to impact their second largest expense – healthcare. They also look at a few key provisions that allow Cameron to lead tribal nations towards financial savings while delivering better health outcomes for their community. Show Notes: Welcome to Impact Healthcare! Lester stars off by introducing Cameron and asking what led him towards healthcare insurance (1:15). The two dive deeper into the intricacies of servicing tribal nations and casinos (4:55) and how self-funded plans also help non-tribal employees as well (15:26). Cameron discusses the Catastrophic Health Emergency Fund and other provisions for tribal entities (17:12). He also discusses how easy it is for employers to implement a self-funded plan and achieve cost savings (36:25).

Description: On this episode of Impact Healthcare, Lester sits down with Emma Fox, COO and Partner of E-Powered Benefits, to discuss healthcare debt and the effect it can have on families. Emma shares some deeply personal stories that drove her motivation to change the industry she has decades of experience in. She also discusses her passion for mentoring and leaves several pieces of advice for employers, advisors, and parents as well. Show Notes: Welcome to Impact Healthcare! Emma Fox begins with a story on her own personal experience with healthcare (1:25), provides a story about her own struggle with bankruptcy and offers advice to those in a similar position (3:38). She also explains how she helps people alleviate their struggle with debt (5:45). The pair discuss direct primary care and its benefits (9:05). Emma breaks down how she helps clients’ lower costs with a few words of advice (18:00). Lester then asks her to explain the genesis of a ‘win, win, win’ for employers, members, and providers (21:51) and talk a bit about her course on self-funding (26:28). Finally, Emma leaves listeners with a piece of advice (30:54).

Description: In this episode, Lester Morales connects with Allison De Paoli, a long-time benefits advisor and advocate for improved employer health benefits plans. She details a powerful story about her mother that sparked the passion for her career and highlights important distinctions about physicians who operate under hospital systems and integrated health networks. Together, Lester and Allison also break down why data is the key to helping employers achieve better outcomes for their workforce. Show Notes: Welcome to Impact Healthcare! Allison De Paoli starts the podcast off by telling a personal story that defines her approach as an advisor (1:55) then proceeds to explain the downsides of physicians that accept network contracts, (8:50) and how their operation changes as a result (11:00). Lester and Allison dive deeper into how this also affects both employers and their employees (16:50). Our guest explains how she helps companies provide better healthcare packages for their workforce (21:35), why data should always come first (24:00), and how patients can achieve the highest quality of care (25:45). The pair close out the episode with guidance for employers looking to offer more cost-efficient healthcare with better outcomes for their employees (32:15).

Description: Happy 2022! In this episode, Lester Morales is solo while he recaps the amazing first year of the Impact Healthcare podcast. He shares a few changes viewers can expect to see over the next year and highlights some of his plans for the show moving forward, such as providing listeners with extra content to put what they hear on the podcast into action. Lastly, he emphasizes the importance of embracing change in order to witness tangible results. Show Notes: Welcome to Impact Healthcare! Lester starts the podcast off by thanking all the listeners for their continued support (00:42) and addresses a few changes to the program in the coming year (1:00). He also discusses how he plans to meet employees, employers, and consumers where they are (3:15), as well as how successes will be highlighted moving forward (6:50). Lester closes out the episode talking about the importance of change (9:27) and his primary mission for the Impact Healthcare podcast in 2022 (10:12).

Lester sits down with Dutch Rojas, Founder of Sano Surgery and Everyone Health, to have a candid conversation on his mission to break down barriers to care by removing copays and deductibles. The two discuss the importance of direct contracts in saving both employers and plan members money. Finally, Dutch also dispels several myths surrounding the relationship between quality and care in the industry and provides several pieces of advice to employers looking to save substantially on their health benefits plan.

Lester interviews Gary Becker, CEO of ScriptSourcing – a brand that helps self-funded employers dramatically reduce pharmacy spend while providing plan members with a $0 copay for name brand and specialty medications. He breaks down exactly how his company is able achieve this through alternative reimbursement methods that many may not be aware of. The two also discuss how incentives between PBMs and employers can oftentimes be misaligned and review some of his successes working in the industry.

Description: Lester interviews Josh Butler, President of Butler Benefits and Consulting to discuss how he impacts healthcare in the public sector. He also explains how him and his team lead clients to healthcare savings of six figures and more. Finally, the two health benefits professionals highlight how employees, employers, and healthcare providers alike all stand to gain from a properly redesigned healthcare plan. Learn more about your ad choices. Visit megaphone.fm/adchoices

Lester interviews Deb Ault, President of Ault Internation Medical Management. Known throughout the industry as Nurse Deb, she discusses how her and her team consistently lead patients to the highest quality of care through their services. Together, Lester and Deb break down the ‘fee-for-service’ healthcare system in the US and how employers can provide their workforce with the highest quality of care for a fraction of what they spend on their current health plan. Learn more about your ad choices. Visit megaphone.fm/adchoices

Lester Morales interviews Jim Blachek from Dynamic Benefit Solutions who shares how his son's suicide REFOCUSED his business. From wanting to only work with employers who value their employees to focusing on building health benefit programs that provide BETTER access and quality care at a LOWER cost. His employee-centric approach is industry changing and he shares his approach, some examples, and his plea with the "status quo industry. Learn more about your ad choices. Visit megaphone.fm/adchoices