Self-Funded With Spencer

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/

In this conversation, Jay Ritchie, President and CEO of Tokio Marine HCC with over 30 years in stop-loss underwriting, shares crucial insights into the tightening stop-loss market for 2025-2026. He highlights the surge in multi-million dollar claims driven by NICU stays and gene therapies, the reasons behind climbing industry loss ratios, and the importance of treating stop-loss partners as collaborators, not commodities. Ritchie emphasizes the role of data in shaping future underwriting strategies and the benefits of active risk management through captives.

John Rutledge, a veteran in employee benefits from Marsh McLennan Agency, dives into the chaotic evolution of health insurance over the past four decades. He reveals how the industry shrank from 25 carriers to just four, significantly limiting competition. Rutledge discusses the impact of the ACA on self-funding and the increasing relevance of alternative risk models like captives. He also emphasizes the crucial need for engaged employers to stabilize costs, push for price transparency, and actively manage their healthcare as a key component of their business strategy.

"Eat your food as medicine or medicine will become your food." - Chef Austin SimmonsCan better beef solve America's health crisis? My guests this week, Chef Austin Simmons of Chef and Rancher and benefits/nutrition expert Chris Pierron, believe it's a critical part of the solution. They join the show to discuss the deep connection between cattle genetics, our broken food system, and our exploding healthcare costs.Chef Austin explains his "hoof to fork" model for creating "better beef." We discuss how using purebred, genetically-verified cattle and clean feeding practices, free of the seed oils and used fryer oil common in the commercial industry, produces a more nutrient-dense and flavorful product.This isn't just about a better steak; it's about creating a healthier population from the ground up. We explore how fixing the food system is the most important step to lowering healthcare costs, and why consumer education is the key to driving this change.Tune in today for a conversation that will change the way you think about the beef on your plate.Chapters:(00:00:00) How Better Beef Can Solve America's Health Crisis (00:05:18) The Hidden Additives & "Poisons" in Most Beef(00:19:38) Why is Prime Beef So Inconsistent? (00:20:58) The Power of Cattle Genetics (00:37:47) Is There Used Fryer Oil In Your Steak? (00:54:22) Should We Federally Subsidize Beef?(01:02:09) Why Food Education is the First Step (01:13:26) Fixing the Food System to Fix HealthcareKey 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 Smith, an accomplished employee benefits sales leader at Hub International, reveals the pitfalls of high healthcare deductibles, arguing they create major barriers to necessary care. He advocates for 'first dollar' coverage, which encourages timely treatment and ultimately lowers costs. The conversation explores innovative plan designs, the importance of tiered networks for directing patients to quality providers, and the role of tech in enhancing benefits. Trey emphasizes how these strategies not only help employees but can also boost recruitment and retention for employers.

Amanda Volner, AVP of Broker Partnerships at Healthee and pharmacy expert, shares her insights on making healthcare more human through AI. She highlights the limitations of AI, emphasizing that critical thinking and personal relationships remain essential. Amanda discusses Healthee's innovative approach to hyper-personalized healthcare experiences, including care navigation and pharmacy cost management. She also opens up about the challenges of balancing her career, single motherhood, and the importance of sobriety in a demanding industry.

"Good entrepreneurs fall in love with their solution and their platform, but great entrepreneurs fall in love with the problem." - Matt ScovilMatt Scovil and Nathan Gilchrist of Medefy Health, have fallen in love with one of the biggest problems in benefits: nobody wants to engage with them. They joined the show to discuss their journey of building a platform designed to solve the engagement crisis and simplify the healthcare experience for everyone.Matt and Nathan break down their "bottoms-up" approach to this problem, which focuses on engaging members when they need help through a high-touch, live support model delivered via mobile app. We discuss how they use the psychology of "loss aversion" and constant communication to drive engagement rates over 90%.We also explore how Medefy acts as the "quarterback" for a health plan, removing friction by navigating members to the right solutions. This is all part of their vision for the future of healthcare, where the experience is "heavily, heavily individualized" for each person.Chapters:(00:00:00) Why Employees Would Rather Clean a Toilet Than Use Their Benefits (00:04:18) Cleaning a Toilet vs. Learning Your Benefits (00:08:46) Falling in Love with the Problem, Not the Solution (00:14:23) The Power of Live, Human Support (00:19:08) Using "Loss Aversion" to Drive Engagement (00:34:54) The Quarterback for Your Health Plan (00:47:57) How AI is Augmenting the Human Touch (01:00:01) The Future of Healthcare is "Individualized"Key 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 think the three strongest words that you can use as a leader, as a salesperson, as a client relationship person is I don't know." - Scott MilsonMy guest this week, 35-year industry veteran and author Scott Milson, joins the show for a deep dive into the mindset required for a long and successful career. We discuss his journey from a self-described "career B student" to a partner at a major firm, and the lessons he learned about loyalty, hard work, and what it truly means to be excellent.Scott breaks down his personal playbook for "tuning into the frequency of excellence." He shares his "Be 5 Framework" (Be Present, Curious, Intentional, Bold, and Reflective) and explains why embracing discomfort, adopting a growth mindset, and learning through informal mentorship are crucial for professional growth.It’s worth noting that Scott is also professionally in the benefits industry, so I wanted to have him on the show to directly speak to those in this space.I hope you'll tune in for this insightful conversation!Chapters:(00:00:00) Tuning Into The Frequency Of Excellence (00:20:08) Why Discomfort is the Path to Growth (00:21:56) The 3 Words That Defeat Imposter Syndrome (00:27:52) The "Success to Significance" Curve (00:38:42) The “Be 5” Framework for Excellence (00:40:52) The Myth of Formal Mentorship (00:48:25) "How You Do Anything is How You Do Everything"Key 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/