Self-Funded With Spencer

Will Bruhn, CEO and co-founder of Global Appropriateness Measures, sheds light on a shocking statistic: 21% of medical care is unnecessary. He discusses how traditional quality metrics focus too much on outcomes rather than appropriateness, leading to wasteful practices in healthcare. Real-world examples, like unnecessary spinal fusions and the surge in Friday afternoon C-sections, reveal financial incentives at play. Will also outlines how data can steer patients towards high-value care, ultimately aiming to eliminate this wasteful spending.

Cory Morin, Co-founder of Benji Card, is a fintech entrepreneur transforming healthcare payments with his innovative virtual wallet strategy. He discusses how giving care coordinators instant access to funds can significantly lower medical claim costs. Cory reveals how Benji Card enables immediate payments to providers, leading to substantial discounts for employers. He believes this model could make traditional PPO networks obsolete and predicts a future of tiered zero-dollar benefits in healthcare. Tune in to discover this revolutionary approach to cost containment!

If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions. This month, we’re joined by Chris Hamilton! We talk about the J&J lawsuit being dismissed, Eli Lilly switching PBMs, AI in healthcare, and much more. We also play a Christmas game called Home Alone: The Wet Bandit's Bills, where Chris and I try to guess the average hospital price for the injuries incurred by the bandits from the Home Alone films.Chapters: 0:00 - Intro0:42 - J&J Lawsuit Dismissed9:20 - Eli Lily Switches PBMs11:17 - New FDA Rules On Biosimilars16:36 - AI Adoption In The Healthcare Industry25:21 - Survey On At-Home Medical Devices29:57 - Home Alone: The Wet Bandit's Bills42:32 - Ask Spencer AnythingSources: https://www.healthcaredive.com/news/fda-biosimilars-guidance-speed-development-comparative-efficacy-studies/804191/https://www.beckerspayer.com/legal/judge-dismisses-lawsuit-accusing-jj-of-mismanaging-employee-drug-benefits/?origin=PayerE&utm_source=PayerE&utm_medium=email&utm_content=newsletterhttps://www.healthcare-brew.com/stories/2025/11/25/eli-lilly-switches-big-3-pbm-alternative-transparent-rivalhttps://www.fiercehealthcare.com/health-tech/amid-shutdown-health-it-vendors-say-hospitals-are-cutting-back-spendinghttps://www.techtarget.com/virtualhealthcare/news/366633680/Survey-At-home-monitoring-devices-popular-affordablehttps://pubmed.ncbi.nlm.nih.gov/41265449/https://www.emarketer.com/content/ai-spending-healthcare-outpaces-overall-us-economy-

"Success leaves clues. And sometimes that clue is healthy leadership that is just able to take them from plateau to plateau." - Trey MarinelloMy guest this week, Trey Marinello of Houlihan Lokey, is an expert in a topic everyone is constantly talking about: Private Equity. Trey joined the show to demystify the world of investment banking and explain exactly why private equity firms are pouring billions of dollars into the employer-sponsored healthcare space.Trey breaks down the current trends, explaining why PE isn't just about leverage and debt, but about "turning the propeller faster" through distribution expertise and strategic growth. We discuss why categories like TPAs, cost containment, and innovative funding models are red-hot, while "wellness" and "population health" have struggled to prove their ROI.We also explore the potential of AI to revolutionize mental health care, why “ICHRA” is still a wild card, and how smart brokers are becoming essential value-drivers in M&A deals.Tune in for a masterclass on following the money in healthcare!Chapters:(00:00:00) Why Private Equity is Pouring Billions Into Employer Healthcare(00:00:35) Why Private Equity Loves Healthcare (00:08:59) What Does an Investment Banker Actually Do? (00:17:25) How PE Firms Use Distribution to Scale (00:20:06) Is ICHRA the Future or a Fad? (00:28:50) The Rise of Alternative Funding (00:42:34) Why "Wellness" Investments Failed (00:57:16) How Brokers Drive Enterprise Value (01:02:47) The Hottest Category in Healthcare M&AKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"I love working with people who aren't afraid to own up to their mistakes. Integrity is the most important thing to me." - Cara KirschWhat is the secret to a perfect broker-partner relationship? My guests this week, Cara Kirsch and Libby Henry, join the show to answer that question. They share the story of how a single "virtual lunch" during the pandemic sparked one of the most effective partnerships in the industry.Cara and Libby break down the ingredients of their success: radical transparency, the ability to have difficult conversations without breaking trust, and a shared commitment to integrity. We discuss why the best partnerships aren't just about the lowest spreadsheet number, but about who you can trust when things go wrong.We also dive into the results of this partnership, including how they worked together to turn a client's 74% fully insured renewal into millions in savings. Plus, we explore the reality of balancing high-powered careers with motherhood and why women need to claim their seat at the table.Tune in to learn how to build business relationships that actually last.Chapters:(00:00:00) The Secret to a Perfect Broker-Partner Relationship (00:05:07) The "Virtual Lunch" That Started It All (00:15:20) Why Honesty Trumps Being "Nice" (00:18:04) Building Trust Through Intentionality (00:21:57) Balancing Motherhood & A Career (00:42:22) Turning a 74% Renewal into Savings (00:44:08) Why Strong Partnerships Close More DealsKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Trey Halbert, CEO of ExperINS and expert in strategic employee benefits, highlights the shift from traditional brokers to modern consultants. He emphasizes aligning benefits with business strategies and notes how AI can enhance consultants' roles by taking over mundane tasks. Trey shares insights on self-funding's benefits, the importance of a mission-driven approach, and the value of peer networks. He advocates for using benefits as a tool for business valuation and encourages a cultural focus that prioritizes impactful service.

Mark Masson, President of Renalogic, dives into the alarming reality of chronic kidney disease (CKD), impacting 1 in 7 Americans, with 90% undiagnosed. He reveals how a duopoly inflates dialysis costs by 700-900% above Medicare rates. The discussion includes proactive management to slow CKD progression, the advantages of home dialysis, and the significant financial savings for employers through better intervention strategies. Mark emphasizes the critical need for early detection and competition within the healthcare market to tackle this silent killer.

Sasha Gribov, founder of Milu Health, is revolutionizing healthcare with AI-driven 'early warning' systems. He explains how AI can predict surgeries up to 90 days in advance, enabling proactive patient outreach. Gribov discusses the necessity of integrating health data to identify care needs before they escalate into catastrophic claims. He passionately argues that AI will augment doctors, enhancing care rather than replacing human expertise. Tune in for insights on building a forward-looking healthcare system that saves lives and cuts costs!

Kyle Minick, a guest expert on physician workforce issues, dives into pressing healthcare concerns. He discusses how physician stress is reaching pandemic levels again, driven by rising patient loads and changing reimbursements. Over half of healthcare workers are considering job changes due to feeling undervalued. AI scribes are highlighted as a promising solution to reduce burnout by cutting documentation time. The episode also explores how millions lack access to telehealth due to unreliable internet, creating healthcare deserts. Tune in for insights and a fun game guessing pharmaceutical commercials!

“Just because someone hasn't gone to the doctor in four years does not mean they're not a walking time bomb." - Garrett JerueMy guest this week, Garrett Jerue, argues that the key to solving our healthcare crisis is to think differently and build a truly cohesive healthcare ecosystem. Driven by his personal experience battling cancer and navigating a fragmented system, Garrett has dedicated his career to designing benefits strategies that actually work for people.In this episode, Garrett shares his playbook for building this ecosystem. We discuss the "Ticket Health" model he developed, which integrates direct primary care, transparent PBM partnerships, and robust care navigation into a seamless experience. He explains why treating members with dignity and choice, focusing on proactive care, and challenging the status quo are essential ingredients for success.We also dive into the critical importance of mental health support and why employers need to view their health plan not just as an expense, but as a living, breathing organism that requires constant care and innovation.Tune in to get Garrett and I’s insight on building a healthcare ecosystem that truly serves people.Chapters:(00:00:00) Building A Cohesive Healthcare Ecosystem (00:10:24) How a $600k Cancer Bill Changed Garrett’s Life(00:17:22) Why Healthcare Financing Needs a Rethink (00:25:28) Treating Members with Dignity & Choice (00:38:11) The Keys to a Transparent PBM Partnership (00:43:45) Direct Primary Care: The Foundation of the Ecosystem (00:50:26) Care Navigation: The Glue That Holds It Together (00:59:07) Making Mental Health a Priority in the Ecosystem (01:12:32) The "Think Different" Mindset for Healthcare InnovationKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/