"Any time you can reward employees for doing the right thing, to me, it's benefiting the employer group, it’s benefitting everybody.” - David Mallen You can provide employees with the best healthcare benefits in the world, but if they don’t know how to navigate the healthcare system, those benefits aren’t very effective. David Mallen, EVP of Partnerships at HealthJoy, joined me this week in studio to discuss care navigation and how we make benefits plans more effective for employees.  Having personally used Healthjoy, I think there’s immense value in a care navigation solution like this; we need to empower healthcare consumers to understand that they can often get the same/better care for cheaper, both to them and the health plan. Chapters: 00:00:00 Meet David Mallen 00:04:42 From Baseball to Healthcare 00:07:28 Healthcare Advocacy 00:18:56 Personalized Healthcare Navigation 00:21:34 Streamlining Healthcare Benefits 00:23:45 Personalized Patient Care 00:36:03 Enhanced Healthcare Interactions For Patients 00:41:54 Healthcare Experiences That Are Backed By Data 00:47:23 Empowering Consumers To Make Decisions Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  HealthJoy, Healthcare Tech, Care Navigation, Digital Healthcare, virtual care, Wellness, wellness programs, baseball, advocacy, advocate, Healthcare Integration, FitnessJourney, Telemedicine, Member Experience, Future Healthcare, Preventive Health, podcast, benefits, health, healthcare, health insurance, self funded, self funding #HealthJoy #HealthcareTech #CareNavigation #DigitalHealthcare #virtualcare #Wellness #wellnessprograms #baseball #advocacy #advocate #HealthcareIntegration #FitnessJourney #Telemedicine #MemberExperience #FutureHealthcare #PreventiveHealth #podcast #benefits #health #healthcare #healthinsurance #selffunded #selffunding

"Looking back now, cancer gave me something to fight for at a time when I felt like maybe life wasn't worth fighting for." - Dylan Slattery Dylan Slattery, VP at ClaimsBridge and motivational speaker at Stage Four 2 On Stage, joined me this week to share his powerful story of beating stage four cancer against all odds, beating it again when it recurred, and how that experience completely changed his perspective on life and healthcare. Dylan was diagnosed with stage 4 melanoma completely out of nowhere at the age of 23. We discussed the traditional treatment plan that he initially followed, and the somewhat experimental immunotherapy treatment that actually worked.  We also discussed the impact that diagnosis had on his family, his friends, and him, what kept him fighting in his darkest moments, and why he wants to continue to share his story to inspire others.  Chapters: 00:00:00 Meet Dylan Slattery 00:11:33 Stage Four Melanoma Diagnosis 00:19:47 Dylan’s Healthcare Journey 00:27:21 Why Immunotherapy Worked For Dylan 00:38:07 Melanoma Reoccurrence and Recovery 00:48:24 Simplifying Healthcare Communication 00:53:29 Enhancing Employee Well-being Through Healthcare 00:55:56 The Financial Barriers in Accessing Healthcare Services Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  melanoma, terminal, immunotherapy, cancer survivorship, healthcare journey, healthcare costs, cancer awareness wellness management, patient advocacy, survivor, cancer, stage four, stage 4, podcast, health, healthcare, health insurance, self funded, self funding #melanoma #terminal #immunotherapy #cancersurvivorship #healthcarejourney #healthcarecosts #cancerawareness #wellnessmanagement #patientadvocacy #survivor #cancer #stagefour #stage4 #podcast #health #healthcare #healthinsurance #selffunded #selffunding

“I’m going to say something that people claim isn’t true, but it is. I’m an ear nose and throat doctor. I don't remember your eardrum from last year. I don't care what people tell you, doctors don't remember 3,000 eardrums.” - Danish Nagda Danish Nagda, founder of Rezilient, has come up with a pretty unique solution to doctor burnout in primary care: a hybrid model, where patients go in-person to checkups, an attendant takes all of their vital signs, and the data is uploaded directly to a doctor.  As an ear, nose, and throat doctor himself, Danish understands the importance of the human touch in healthcare, but also sees the future of primary care as data-based: for instance, if a doctor has your exact EKG readings from a year ago, they have a baseline to measure your current data off of.  Rezilient haș also focused on making all of this appealing to employers, and he shares why this model has positive ROI within the first year for most.  Join us this week as we explore the future of primary care!  Chapters: 00:00:00 Meet Danish Nagda 00:01:02 The Future Of GLP-1s 00:06:19 Comprehensive Healthcare Access 00:09:58 Physician Burnout 00:14:04 Healthcare Should Focus On Data 00:17:54 Tech-Focused Primary Care 00:26:24 The Importance Of The Primary Care Doctor 00:47:05 The ROI Of Rezilient For Employers 00:51:09 Empowering Patients Through Accessible Healthcare Data 01:01:42 The Future Of Rezilient Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Obesity Drugs, GLP1s, GLPs, Physician Mental Health, Rezilient, Concierge Medicine, Tech Enabled Care, Healthcare Transparency, Healthcare AI, Healthcare Innovation, Virtual Care Model, virtual care, podcast, primary care, doctor, health, healthcare, health insurance, self funded, self funding #ObesityDrugs #GLP1s #GLPs #PhysicianMentalHealth #Rezilient #ConciergeMedicine #TechEnabledCare #HealthcareTransparency #HealthcareAI #HealthcareInnovation #VirtualCareModel #virtualcare #podcast #primarycare #doctor #health #healthcare #healthinsurance #selffunded #selffunding

"In what other industry could a purveyor put out 99% bad bills and stay in business?" - Linda Komisak “They're diagnosing things for things that you don't even have. And that’s scary.” - Kimberly Carleson Kimberly Carleson, CEO of US Beacon, and Linda Komisak, founder of Upturn Consulting LLC, joined me to talk about two critical ways of increasing healthcare transparency: claims reviews and quality metrics.  These two topics are key to understanding why the healthcare system is so broken. If you buy any other service, you can (a) expect to only be billed for the services that were performed and (b) have the ability to research the quality of vendors and pick the best one.  Why can’t we do that in healthcare?  This is an incredibly informative episode, and we cover more than just those two topics including nurse staffing shortages, how to identify the best hospital systems, and why it’s so important to gather feedback from nurses.  Chapters: 00:00:00 Meet Kimberly Carleson and Linda Komisak 00:01:11 Taking Feedback from Nurses 00:06:30 Nurses' Impact on Hospital Quality 00:11:31 Why Are There Nursing Shortages? 00:18:18 Nurse Advocacy for Enhanced Patient Experience 00:25:18 Quality Metrics and Patient Billing Integrity 00:39:11 The Importance of Nurse Feedback 00:49:17 Surgeon Incentives in Billing 00:58:12 Healthcare Cost Savings Through Billing Review Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Healthcare Quality, Nurse Insights, Patient Experience, Claims Integrity, Quality Metrics, Upcoding Practices, Nursing Shortage, Billing Transparency, Nurse Anonymity, Healthcare Billing, Hospital Quality, Nurse Feedback, insurance, nursing, healthcare, health insurance, podcast, self funded, self funding #HealthcareQuality #NurseInsights #PatientExperience #ClaimsIntegrity #QualityMetrics #UpcodingPractices #NursingShortage #BillingTransparency #NurseAnonymity #HealthcareBilling #HospitalQuality #NurseFeedback #insurance #nursing #healthcare #healthinsurance #podcast #selffunded #selffunding

"Quit tolerating mediocrity. Go get in action. Find the right broker consultant that will take you to a new place. Don't give up hope." - Scott Conard Dr. Scott Conard tragically lost 3 patients one summer to unexpected heart problems, and immediately changed how he thought of healthcare. This week on Self-Funded, we talk about “conscious capitalism”, and by extension “conscious healthcare”, what the 7 numbers that everybody needs to know are, and how we need to change the way we approach health risk. Chapters: 00:00:00 Meet Scott Conard 00:02:08 Crony Capitalism In Healthcare 00:06:34 Focus On Aligning Incentives 00:15:38 Holistic Well-being Approach To Healthcare 00:27:12 Revolutionizing Self-Insurance 00:37:54 Healthcare Advocacy And Engagement 00:42:22 How Do We Get People To Care About Their Health? 00:49:08 Primary Care's Role in Healthcare Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Conscious Capitalism, Employer Driven Healthcare, insurance, healthcare, health insurance, Empowering Employers, Incentive Programs, Risk Management, Alternative Risk, health risk, fixing healthcare, selffunded, podcast #ConsciousCapitalism #EmployerDrivenHealthcare #insurance #healthcare #healthinsurance #EmpoweringEmployers #IncentivePrograms  #RiskManagement #AlternativeRisk #healthrisk #fixinghealthcare #selffunded #podcast

"It's progress we couldn't have envisioned decades ago." - Oscar “I felt interested in being part of something bigger than my practice and something that will impact even more people that I was able to in the hospital.” - Carolina Dr. Oscar Bronsther and Dr. Carolina Escobar from Interlink joined me this week to discuss the exciting and scary world of cell and gene therapy, CRISPR, and how we fund these amazing medical advances.  In addition to me attempting to act smart enough to be in the same room as these two, we covered their wholistic approach to this emerging scientific field, which promises potential cures for rare and debilitating diseases, but often comes with 7-figure price tags. The rare genetic diseases are known as “orphan diseases”, and there have been some recent incredible advances in detecting them early on in life. We talked about what this all means for individuals as well as the insurance space as a whole, and how it has the potential to increase medical costs in this country even further.  Chapters: 00:00:00 Meet Oscar and Carolina 00:09:16 Genetic Therapy Solutions for Orphan Diseases 00:14:39 Detecting and Targeting Single Gene Mutations 00:26:52 CRISPR Technology 00:30:08 Equitable Access To Gene/Cell Therapy 00:37:21 How Do We Finance This? 00:46:13 The Ethical Concerns Of Cell/Gene Therapy 00:59:45 Economic Implications of This Technology Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Rare Diseases, Gene Therapy, CRISPR technology, CRISPR, Healthcare Skepticism, Healthcare Warranties, Medical Revolution, Healthcare Advances, Orphan Diseases, Cell Therapy, Healthcare Innovation, self funded, podcast #RareDiseases #GeneTherapy #CRISPRtechnology #CRISPR #HealthcareSkepticism #HealthcareWarranties #MedicalRevolution #HealthcareAdvances #OrphanDiseases #CellTherapy #HealthcareInnovation #selffunded #podcast

"If my child needs a gene therapy to live, they should get it and anyone's child should. So let's figure out how to pay for it." - Jake Frenz On the final of four podcasts filmed at a recent healthcare thinktank I hosted in Frisco, Texas, Jake Frenz, the founder and CEO of SmithRx, joined me to share his journey from the Marine Corps to Pharmacy Benefit Management, and what makes him so passionate about ending prescription drug price gouging.  Jake and I discussed what some of the core challenges are in the PBM space, why he was so inspired by Mark Cuban’s venture Cost Plus Drugs, and what the “watershed” moment in US healthcare will look like.  I’m grateful to have had the opportunity to talk to one of the best minds in the PBM space, and I hope you enjoy this week’s episode of Self-Funded with Spencer. Chapters: 00:00:00 Meet Jake Frenz 00:08:06 Consumer-Driven Healthcare 00:15:53 Transparency in the PBM Industry 00:20:57 The “Watershed Moment” in US Healthcare 00:36:14 Mark Cuban's Innovative Healthcare Venture 00:39:34 Subscription-Based Models Disrupting Pharmacy Competition 00:52:34 Revolutionizing Healthcare 00:55:14 Empowering Americans to Drive Healthcare Reform Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Healthcare Insights, Pharmacy Benefit Managersm, Simplify Healthcare, Watershed Moment, Cost Plus, cost plus drugs,  mark cuban, Big Picture Healthcare, American Spirit, Healthcare Innovation, Affordable Medications, price gouging, self funded, podcast #HealthcareInsights #PharmacyBenefitManagers #SimplifyHealthcare #WatershedMoment #CostPlus #costplusdrugs #markcuban #BigPictureHealthcare #AmericanSpirit #HealthcareInnovation #AffordableMedications #pricegouging #selffunded #podcast

Dan Cochran, CEO of Cochran Health Ventures, sheds light on the often-overlooked complexities of healthcare. He discusses the importance of in-home healthcare options and personalized services for patients. The conversation delves into the dynamic between payers and providers, emphasizing the need for consumer education. Cochran advocates for transparency, innovative solutions for managing healthcare costs, and empowering individuals to make informed decisions. His insights challenge listeners to rethink their approach to navigating healthcare.

"There can be a better path forward. We don't have to remain adherent to the system that is built against us. It's just going to take some rolling up of the sleeves and a commitment to it." - Shawn Sanford This week, another ParetoHealth colleague joins the show: Shawn Sanford, RVP of Sales and Pod Leader. Shawn and I discussed his transition from pro baseball to ancillary benefit sales to Pareto, and what he learned from each step along the way.  We also discuss some of the biggest problems in this industry and why they excite Shawn so much, and what he sees as the single biggest case of “highway robbery” in healthcare.  Join us this week on Self-Funded as we discuss the opportunity we have to fix healthcare.  Chapters: 00:00:00 Meet Shawn Sanford 00:14:02 An Unexpected Career Transition Into Insurance 00:22:43 The Importance Of Networking In Sales 00:25:48 Building Trust With Brokers 00:31:39 Transition to ParetoHealth 00:42:25 Having The Right Sales Process 00:51:49 Equity and Transparency in Healthcare 00:55:54 Aligning Incentives Properly  Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Sales Success, Career Transition, Relationship Building, Healthcare Reforms, Insurance Industry, Education Matters, Sales Process, Healthcare Awareness, Healthcare Challenges, Healthcare Transformation, Sales Networking, Career Advancement, self funded, podcast #SalesSuccess #CareerTransition #RelationshipBuilding #HealthcareReforms #InsuranceIndustry #EducationMatters #SalesProcess #HealthcareAwareness #HealthcareChallenges #HealthcareTransformation #SalesNetworking #CareerAdvancement #selffunded #podcast

“There's a reason why every insurance carrier likely owns or is owned by a pharmacy benefit management company, that’s one of the ways that they can drive revenue." - Kristen Rivers My guest this week, Kristen Rivers from ParetoHealth, is one of the strongest healthcare advocates I know.  This week on Self-Funded, Kristen and I discuss her upbringing, how that affects the work she does today, what caused her to leave a position at the biggest insurance company in the world, and why she believes in the work she’s doing at ParetoHealth today. Along the way, we talk about some of the biggest problems in healthcare, from the user experience to misaligned incentives that profit from driving up the cost of healthcare.  The main takeaway: we need more advocates like Kristen if we’re going to fix this industry. Chapters: 00:00:00 Introducing Kristen Rivers 00:08:16 Kristen’s Introduction To Health Insurance 00:16:10 The Importance of Data Transparency and Choice 00:19:50 Advocating For Better Healthcare 00:33:23 Renewal Increases in California Insurance Market 00:35:18 Medicare Cuts 00:41:18 Employer-led Healthcare Plans 00:51:06 Misaligned Incentives 00:53:26 Driving Down Healthcare Costs through Employer Advocacy Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Healthcare Industry Transition, Transparency Matters, Navigating Healthcare, California Insurance Market, Medicare Cuts, Self Funded Plans Healthcare Quality Metrics Industry Complexities, Employer Advocacy, CAA Regulations, Healthcare System, Cost Management, self funded, podcast #HealthcareIndustryTransition #TransparencyMatters #NavigatingHealthcare #CaliforniaInsuranceMarket #MedicareCuts #SelfFundedPlans #HealthcareQualityMetrics #IndustryComplexities #EmployerAdvocacy #CAARegulations #HealthcareSystem #CostManagement #selffunded #podcast