Self-Funded With Spencer

In this special episode of Self-Funded with Spencer, I am joined by my friend Seth Denson for my first ever live version of the podcast through LinkedIn Live. This episode was previously recorded on 12/20/23, but I wanted to make sure that those who missed it on LinkedIn, still had an opportunity to watch and listen. Seth is the Head of Employee Benefits at Acrisure and he also features daily as a sought after business and market analyst for Fox News, CNN, NewsMax, OANN and more. In this spirit of an AMA, no question was off limits, so we covered things like: Our Hair Routines Seth's Media Life Whether we wear makeup! The role of Wellness Benefits Thoughts on RFP Software ParetoHealth (Captives) Seth's time working at a concert venue Our favorite bands to see live Our 3 favorite books And more! Social Links: Self-Funded's Channel - https://www.youtube.com/ @SelfFunded Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Advanced Medical Strategies - Stacy Borans - Founder of AMS Stacy Borans is a seasoned expert in healthcare technology and data analysis, with a robust background in medical cost management. As a key player at Advanced Medical Strategies (AMS), she has been instrumental in developing software solutions for payment accuracy, risk assessment, and business intelligence in the healthcare industry. Her perspective on healthcare technology and data analysis in medical cost management is shaped by her experiences at AMS, where she noticed excessively high bills during medical reviews and saw an opportunity to work on the financial aspect of cost management. Stacy advocates for transparency in chargemaster pricing and cash pricing, and emphasizes the importance of reference-based pricing. She believes that these strategies can help determine the relevant charge for medical services, although she acknowledges that it may not always result in the lowest price. Join Spencer Smith and Stacy Borans as they delve deeper into this topic on the next episode of the Self Funded podcast. Chapters: 00:01:08 Creative cocktail concoctions 00:06:46 AMS: Innovating Healthcare Management Solutions 00:10:43 Understanding the Financial Impact of Self Funding 00:16:21 Shaping the Future of Healthcare Cost Containment 00:21:13 Healthcare Solutions for Complex Medical Cases 00:27:24 Catastrophic Diagnoses Cost Projections Software 00:33:09 Comprehensive Risk Assessment and Pricing Tool 00:40:38 Achieving Transparency in Healthcare Decision-Making 00:46:32 Analyzing Group Risk Profiles Using Census Data 00:56:26 The Impact of AI on Healthcare Diagnoses Key Links for Social Self-Funded's Channel - 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 Listen on Spotify for Podcasters - https://podcasters.spotify.com/pod/show/spencer-harlan-smith Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words: Medical Strategies, Claims Strategies, Data Analytics, Business Intelligence, Business Intelligence Software, BI Software, Claims Analytics, Insurtech Software, Software for Underwriters, Systems for Carriers, Software for Insurance Carriers, Technology for Insurance, Technology for Insurance Brokers, Tech for Insurance Consultants, Tech for Healthcare, Software for Doctors, Software for Third Party Administrators

Josh Honaker is a seasoned pediatrician from South Central Kentucky, renowned for his expertise in integrating telehealth and education in pediatric healthcare. He currently serves as the CEO of Parent MD, a platform that embodies his belief in the necessity of Telehealth and education as solutions to common frustrations and disconnects in pediatric healthcare. Dr. Honaker's perspective is shaped by his experiences with time constraints and high patient volumes, which often leave parents feeling frustrated and uninformed. He sees Telehealth and education as vital tools to improve healthcare access and provide parents with reliable information and resources. Honaker envisions Parent MD as a platform that unites Telehealth partners, educational content, and a supportive community to enhance the medical home and provide comprehensive care for children. Join Spencer Smith and Dr. Josh Honaker on this episode of the @SelfFunded with Spencer podcast to delve deeper into this innovative approach to pediatric healthcare. Key Words: Telehealth, Direct Primary Care, DPC, Pediatrics, Pediatrics Telehealth, Parents, Education for Parents, Community for Parents, Resources for Parents, Employee Benefits for Parents, Healthcare, Employee Benefits, Benefits Brokers, Insurance Brokers, Insurance Consultants, Employer-Sponsored Healthcare, Innovations in Healthcare Key Links for Social Self-Funded's Channel - 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 Listen on Spotify for Podcasters - https://podcasters.spotify.com/pod/show/spencer-harlan-smith Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Chapters: 00:00:00 Virtual Pediatrician Partnership for Holistic Childcare 00:03:57 The Impact of Mentorship on Choosing Pediatrics 00:14:56 Entrepreneurial Pediatric Care: A Unique Approach 00:21:44 Virtual consultations for comprehensive pediatric care 00:28:58 "Comprehensive Digital Resource for New Parents" 00:37:39 Expanding direct-to-consumer model to employers 00:43:48 Future plans for personalized nutrition education 00:46:22 Transforming Healthcare Delivery for Cost-Effective Care 00:52:11 Revolutionizing Healthcare with AI 00:56:11 Advancements in healthcare for optimal human health

How Should Insurance Brokers Get Paid - Jonathan Lopez Jonathan Lopez's career journey is a testament to the power of hard work and continuous learning. From a shoulder injury in the Marine Corps to earning a doctorate in leadership, Lopez has overcome obstacles and embraced opportunities to shape his professional path. Lopez's commitment to helping others extends beyond his career. He is actively involved in fundraising for wells in Tanzania through the Water Boys organization. This philanthropic effort not only builds wells but also ensures their maintenance and management, providing clean water to communities in need. In a recent episode of the podcast "Self Funded," hosted by Spencer Smith, Lopez and Smith delve into the complexities of incentives in the insurance industry. They emphasize the importance of transparency and integrity in navigating this field. Lopez highlights the issue of misaligned incentives and what he refers to as "dark money," shedding light on the need for greater accountability. The conversation also touches on shared savings arrangements and compensation structures for consultants. The evolving landscape of the insurance industry demands a closer examination of who gets paid and how much at each step of the equation. Lopez and Smith recognize the need for more transparency and integrity in the industry, challenging the perception of insurance as a greedy or stagnant field. Comedy emerges as a powerful tool for delivering harsh truths and sparking meaningful conversations. Lopez and Smith discuss the influence of comedy in addressing industry issues and dispelling misconceptions. They highlight the role of comedians like Joe Rogan, who use their platforms to share perspectives and engage audiences through humor. Artificial intelligence (AI) emerges as a game-changer in the insurance industry, particularly in underwriting and prepayment of claims. Lopez emphasizes the benefits of AI in analyzing patterns and resolving issues efficiently. The vast amount of healthcare data available allows AI to make data-driven decisions, leading to more accurate risk assessment and cost-saving strategies. Chapters 00:03:29 From $20 to Doctorate: Overcoming Obstacles 00:06:46 Climbing Mount Kilimanjaro to Fund Wells 00:09:58 Sustainable well management for clean water access 00:19:48 Misaligned incentives and dark money in insurance 00:28:33 Incentivized cost savings through shared arrangements 00:34:34 Prescription-based Comp for Insurance Consultants 00:40:25 The Power of Comedy in Delivering Truth 00:41:48 AI's Impact on Claim Management in Insurance 00:50:45 Revolutionizing Underwriting with AI Technology 00:59:27 Optimizing Insurance Plans w/ Pre-Underwriting Analysis

In this episode of the podcast Self-Funded with Spencer, hosted by Spencer Smith and featuring Sam Moen, the co-founder of MD Direct, the discussion centered around MD Direct's unique approach to optimizing healthcare and nutrition. MD Direct is a healthcare company that aims to bridge the gap in hospital nutrition and diet, focusing on individual performance and optimizing knowledge to help patients achieve their health goals. One of the key factors that impact MD Direct's approach is the disconnect in healthcare, particularly in musculoskeletal (MSK) and orthopedic care. This category is the largest spending category for employers in healthcare, accounting for a significant portion of healthcare costs. Sam Moen, co-founder of MD Direct, emphasizes the importance of addressing this issue, stating, "Getting good musculoskeletal health is what we think is the most important problem for employers to solve." Orthopedic care alone accounts for 5.76% of the GDP, making it a significant financial burden on both individuals and employers. The prevalence of musculoskeletal injuries, coupled with the high cost of treatment, highlights the need for a more efficient and effective approach to healthcare in this area. MD Direct aims to optimize healthcare visits, reduce leakage, and improve overall efficiency in the healthcare system. They specialize in triaging patients and determining the most appropriate treatment pathway, prioritizing starting with the least critical intervention. By utilizing data from wearables and predictive analytics, MD Direct aims to improve patient care and outcomes. One of the challenges MD Direct faces is the traditional healthcare model, which is not designed for efficiency. Moen acknowledges this, stating, "The traditional healthcare model isn't designed for efficiency. Unfortunately for you and me, the efficiency really is for the physicians. For billing insurance companies." MD Direct aims to disrupt this model by focusing on delivering the best clinical model to patients, with a focus on rapid diagnosis and treatment. Another important aspect of MD Direct's approach is the integration of nutrition and diet into healthcare. Moen highlights the lack of understanding and coaching on nutrition and diet in hospitals, stating, "The hospitals don't understand anything about nutrition and diet. They don't coach you on anything." MD Direct aims to address this gap by creating a connection between health and wellness, providing patients with the necessary information and support to make informed decisions about their nutrition and diet. MD Direct also works closely with employers to create clinical pathways and engage employees when they need it most. Moen emphasizes the importance of financial incentives for employees, stating, "If you can get the financial incentive to the employees, that's a great way to see engagement tick." By designing benefit plans that make it financially beneficial for employees to choose MD Direct's approach, they aim to increase engagement and improve overall health outcomes. Chapters: 00:00:18 Revolutionizing Hospital Nutrition with MD Direct 00:01:23 The Impact of Gluten on Scandinavian Health 00:05:17 The Lizard Brain's Influence on Food Choices 00:07:44 Disparity in MSK and Orthopedic Care 00:08:30 Optimizing MSK and Orthopedic Care Efficiency 00:15:58 The Impact of Unnecessary Surgeries in Healthcare 00:21:28 High-Value Physical Therapy for Efficient Care 00:26:44 Improving Musculoskeletal Health for Employers 00:31:57 Utilizing MD Direct's Services for Employee Incentives 00:40:39 Reducing Unnecessary Surgeries 00:49:25 Wearable Data for Early Health Notifications

Recruit & Retain with Employee Benefits - Kyle Minick The evolving employer market is placing a greater emphasis on HR policies, benefits, and healthcare transparency. In this episode of the podcast "Self Funded" hosted by Spencer Smith and featuring Kyle Minick, the importance of these factors in talent management strategies was discussed. Traditionally, financial compensation has been the primary focus for employers when it comes to attracting and retaining talent. However, surveys have consistently shown that compensation is not the top priority for employees. Instead, factors such as flexibility and paid time off are often cited as more important. This highlights the need for employers to look beyond monetary rewards and invest in HR policies and benefits that foster a supportive work culture. Creating a sense of value among employees is crucial for retaining them. This can be achieved through leadership that demonstrates emotional attachment and loyalty. Employees want to feel that their employer cares about their success and well-being. HR policies and fringe benefits play a significant role in creating this sense of value. Offering assistance with buying a home or expanding financial futures are examples of how employers can show their commitment to their employees' long-term well-being. The insurance industry is also evolving to offer creative and tangible business solutions. Benefits are a major expense for businesses, and insurance companies are recognizing the need to go beyond traditional coverage. They are now focusing on HR policies, fringe benefits, and talent attraction and retention. Summit, a company specializing in benefits, insurance, and investments, is leading the way in serving businesses of all sizes, with a particular interest in blue-collar companies. They are also taking steps to address the high costs of specialty drugs through new pharmacy initiatives. Chapters: (00:00:08) Podcasts and Education in Employer Market (00:01:24) Creating a Culture of Employee Satisfaction (00:06:05) Creating a Supportive Environment for Employee Retention (00:10:09) Kyle's Journey in the Insurance Industry (00:16:00) Innovative Solutions in the Insurance Industry (00:24:52) Specialized Benefit Solutions for Businesses of All Sizes (00:30:43) Challenges and Solutions for Blue-Collar Companies (00:46:26) Pharmacy Initiatives: Addressing Specialty Drug Costs (00:51:49) Unveiling the Elusive Healthcare Expenses (00:58:08) Disruptive Innovation for Positive Change

The TPA Problem-Solver - Madeline Smith of MADDRS Today's episode features Madeline, CEO and Founder of MADDRS. Madeline Smith is a passionate insurance professional with a diverse background in writing, teaching, coaching, and consulting, and a strong desire to improve differentiation and value in the self-funded plan industry. Madeline sees her role evolving to focus more on teaching, supporting, and consulting behind the scenes, rather than being at the forefront trying to sell and produce. She is a strong advocate for challenging the status quo and finding innovative ways to make a difference in the industry. She criticizes the tendency for some in the industry to cut corners and engage in practices that contradict their claims of being different and radical. Madeline is also the creator of the anthology book - "Whole Lotta $$$ in this MoFo", which is subtitled "An Employer's Guide to Navigating Legalized Larceny Within American Healthcare". I was fortunate to also to a contribute a chapter to this great book. Buy it here - https://www.amazon.com/Whole-Lotta-this-MoFo-Navigating-ebook/dp/B0BLDMZ3NF Join Spencer Smith and Madeline Smith on this episode of the  @SelfFunded  with Spencer podcast to learn more about her unique perspective and commitment to making a positive impact within her own lane. Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=687c57dbe9cb4f39 Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Spencer Website - https://spencerharlansmith.com/ Spencer LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Madeline LinkedIn - https://www.linkedin.com/in/madeline-smith-dba/ MADDRS LinkedIn - https://www.linkedin.com/company/maddrs/ Chapters: 00:01:23 Embracing Unique Strengths: Differentiating MGUs and Carriers 00:04:16 Evaluating carrier relationships for successful partnerships 00:17:32 Improving Communication for TPAs 00:21:45 Mediating and problem-solving in the insurance industry 00:24:53 Misunderstood challenges faced by TPAs in healthcare 00:32:41 Selecting the Ideal TPA for Clients 00:37:06 Prioritizing projects based on shared values 00:40:16 Unveiling the Hidden Forces: A Raw Industry Perspective 00:44:31 Navigating Healthcare: A Comprehensive Guide 00:49:43 Navigating Careers: A Guidebook for Professionals 00:54:59 Driving positive change in the healthcare system

From Military Service to Employee Benefits - Two Veterans' Journey into Healthcare Transitioning from military service to civilian life can be a daunting task for some veterans. However, with the right support and guidance, veterans can find fulfilling careers in various industries. One such industry is insurance consulting, which offers a unique blend of strategic thinking, problem-solving, and client management. In a recent episode of the podcast @SelfFunded with Spencer, hosted by Spencer Smith and featuring Cliff Favors and Winston Elliott, the topic of veterans transitioning to civilian careers in insurance consulting was explored in depth. Networking and Support: Key Factors for Success One of the key takeaways from the episode was the importance of networking and support for veterans transitioning to civilian life. Cliff Favors and Winston Elliott, both veterans themselves and employees at Lockton, emphasized the value of reaching out to others who have already made the transition. They highlighted the Houston veteran community as an excellent resource for connecting with like-minded individuals and gaining insights into different industries. The Rewards of the Benefits Industry Despite its reputation as a potentially dull field, the benefits industry, particularly insurance consulting, offers rewarding opportunities for veterans. Cliff Favors mentioned that the benefits industry is often misunderstood and under-appreciated. He emphasized that the industry plays a crucial role in solving people problems rather than just crunching numbers. By focusing on the human aspect of business, insurance consultants can make a positive impact on the lives of employees and their families. Lockton: A Trusted Partner in Insurance Consulting Lockton, a privately held insurance broker, stands out as a company that prioritizes its clients' interests. Winston Elliott highlighted the unique advantage of being privately held, as it allows Lockton to focus solely on serving its clients without external pressures from shareholders or private equity firms. The company's commitment to comprehensive support was evident in its approach to medical coding and identifying questionable claims. With a team of medical doctors and coding experts, Lockton goes beyond traditional insurance brokers, acting as trusted advisors to business owners and CFOs. The People Solutions Approach Lockton's people solutions approach sets it apart from other insurance brokers. Rather than simply offering cost-saving solutions, Lockton aims to be a trusted advisor to its clients. By addressing not only healthcare concerns but also broader business challenges such as retention, compensation, and leadership development, Lockton positions itself as a strategic partner in the growth and success of its clients' businesses. Tradeoffs and Challenges While transitioning to a civilian career in insurance consulting can be rewarding, it is not without its challenges. Spencer Smith, the podcast host, highlighted the need for consultants to be proficient in their subject matter. The complexity of the healthcare industry requires consultants to continuously update their knowledge and skills to provide the best solutions for their clients. Additionally, veterans transitioning to civilian life may face the challenge of translating their military experience into relevant skills for the insurance consulting field. However, with the right support and networking opportunities, these challenges can be overcome. In conclusion, veterans transitioning to civilian careers in insurance consulting have a unique set of skills and experiences that can be valuable in this field. By leveraging networking opportunities, seeking support from veteran communities, and aligning with companies like Lockton that prioritize client interests and comprehensive support, veterans can find fulfilling careers in insurance consulting.

In this episode of the podcast @SelfFunded with Spencer, hosted by Spencer Smith and featuring Paul Pruitt, the topic of addressing high medication costs in healthcare was discussed. The episode shed light on the challenges faced by individuals and employers due to the financial burden of expensive medications and explored potential solutions to alleviate this issue. Paul Pruitt, CGO of SHARx, shared his personal experience of spending $1.8M on annually on medication for his family. This staggering amount highlights the significant impact that high medication costs can have on individuals and their loved ones. SHARx aims to address this problem by offering a medication procurement optimization platform that simplifies the process of accessing expensive medications not covered by traditional health insurance. One of the key factors discussed in the episode is the importance of personalized healthcare. Pharmacogenomics, which involves studying how an individual's genetic makeup affects their response to medications, was highlighted as a potential solution. By understanding a patient's genetic profile, healthcare providers can optimize their treatment plans and avoid prescribing medications that may have negative effects or provide no benefit. This personalized approach can lead to better health outcomes and potentially reduce medication costs. However, implementing pharmacogenomics in healthcare comes with its own set of challenges. The episode emphasized the need for an appetite for this approach and ensuring that it doesn't compete against other priorities in the healthcare industry. Balancing the adoption of new tech and approaches with existing practices and systems is a tradeoff that needs to be considered. Another aspect discussed in the episode is the role of patient assistance programs (PAPs) in helping uninsured or underinsured individuals access free or discounted medications. PAPs provide financial assistance to eligible patients, making medications more affordable and accessible. Exploring alternative sources for medications, such as sourcing from countries like Canada where prices are more affordable, was also mentioned as a potential solution. The episode highlighted the challenges faced by employers in providing affordable healthcare benefits to their employees. The high cost of medication is a pressing issue that affects both employers and employees. Solutions like those offered by SHARx aim to alleviate this burden by providing medications at zero out-of-pocket cost and offering a more sustainable approach to healthcare coverage. The current healthcare system in the United States was also discussed as a contributing factor to high medication costs. The supply chain from manufacturers to wholesalers, pharmacies, and patients is often manipulated and broken, leading to inflated prices. The pay-to-play mentality and rebates between different players in the supply chain further complicate the issue. Patients rarely benefit from these rebates, and the cost savings are not passed on to them. In conclusion, addressing high medication costs in healthcare requires a multi-faceted approach. Personalized healthcare through pharmacogenomics, patient assistance programs, and exploring alternative medication sources are potential solutions. However, implementing these solutions comes with challenges and tradeoffs. Chapters: 00:01:23 The Potential of Pharmacogenomics in Healthcare 00:08:07 The Financial Strain of High Medication Expenses 00:10:04 Healthcare Solutions for Expensive Medications 00:18:23 Understanding Individual Healthcare Experiences 00:20:50 A Convenient Alternative for Affordable Medication 00:27:03 Accessing Free or Discounted Medications through PAPs 00:33:13 Affordable Medication Sourcing from Abroad 00:43:29 The Delicate Balance of Medication Cost 00:51:00 Timing and Players in Solution Deployment

Pharmacogenetics: Personalized Medicine for the Future In a this episode of the podcast "Self Funded" hosted by Spencer Smith, entrepreneur Nick Glimcher shared his journey from the world of commercial real estate to the healthcare industry. Glimcher's story highlights the importance of adaptability and seizing opportunities in different industries. He emphasizes the link between powerlifting and entrepreneurship, both requiring consistent effort and commitment for success. One of the key challenges in the healthcare industry, as discussed in the episode, is the complex landscape of insurance companies and payment issues. These challenges can be daunting and hinder the delivery of quality care. However, Glimcher believes that precision medicine holds the key to overcoming these challenges and revolutionizing healthcare. Precision medicine is an innovative approach that provides detailed and targeted care based on an individual's genetic makeup. Glimcher explains that precision medicine is the future of healthcare, with pharmacogenetics playing a crucial role in personalizing treatment plans. Pharmacogenetics is the science of determining which drugs work for an individual and which do not. While the science has been commercially viable since 2010, its widespread usage has been limited due to applicability issues. To address this issue, Glimcher's company, Blue Genes, has developed a software tool called The Blue Genes Solution. This tool aims to make pharmacogenetic data actionable in clinical settings. By integrating with pharmacy benefit managers (PBMs) and electronic medical records (EMRs), Blue Genes simplifies the interpretation of pharmacogenetic reports and provides instantaneous notifications to healthcare providers, ensuring that prescriptions are genetically efficacious. Cost mitigation in healthcare is a pressing issue that requires innovative solutions, such as precision medicine, and bipartisan support. Glimcher highlights the importance of government involvement in pushing for coverage determinations and legislation related to pharmacogenetics. He believes that there is bipartisan support for healthcare reform because humanity and caring are not political issues but fundamental aspects of being human. The episode also touches on the challenges faced by healthcare providers in adopting technology. Healthcare has been the last sector to embrace technological advancements, despite its critical role in keeping people alive and healthy. Glimcher emphasizes the need to make it easy for providers to integrate new technologies ethically, as they are motivated to provide the best care for their patients. In conclusion, the episode of "Self Funded" featuring Nick Glimcher sheds light on the intersection of entrepreneurship, healthcare challenges, and precision medicine innovations. Glimcher's entrepreneurial journey and insights highlight the importance of adaptability and consistent effort in achieving success. The challenges in the healthcare industry, particularly with insurance companies and payment issues, can be overcome through precision medicine and the integration of pharmacogenetic data. The efforts of companies like Blue Genes are aimed at improving clinical outcomes and mitigating the rising costs in healthcare. With bipartisan support and a focus on humanity and caring, the future of healthcare looks promising. Chapters: 00:01:22 Nick Glimcher's Journey of Adaptability and Opportunity 00:04:41 The Importance of Consistent Effort in Powerlifting 00:08:13 Insurance Payment Challenges in Healthcare 00:12:08 Pharmacogenetics: Personalized Medicine 00:18:00 Overcoming Limitations of Pharmacogenetic Testing 00:27:42 Genetic Makeup's Impact on Drug Effectiveness 00:32:07 Transforming Healthcare with Niche Data Analysis 00:46:02 Precision Medicine for Cost Mitigation in Healthcare