Self-Funded With Spencer

"I don't believe that random doctors should treat random patients in ongoing continuity of care. I don't think that transactional care is good for patients, and I know it's not good for physicians." - Chris Mathew The great Chris Mathew, Chief Growth Officer at Sniffle, joined me to talk about the future of Telehealth and the amazingly cost-effective ($15 a month!) benefits plan that Sniffle offers.  Chris comes from an entrepreneurial family background, which pushed him to work at various startups over the years. Chris and I talked about why it was so important for him to be part of a startup even when he didn’t immediately see success, and how that drive led him to where he is today.  Chris is really passionate about making the experience of healthcare better for both patients and physicians, and Sniffle’s “Aignosis”, an AI diagnosis tool, plays a big role in making doctor’s visits more effective and personal.  Join us this week for a conversation on making doctor’s and patient’s lives better, and learning just how Sniffle can offer so many amazing benefits for just fifteen dollars a month.  Chapters: 00:00:00 Meet Chris Mathew 00:08:09 Entrepreneurial Success Through Resilience and Perseverance 00:14:20 Student Debt Impact on Physicians 00:18:42 Real-time Savings with Sniffle Rx Platform 00:30:05 Seamless Virtual Consultation Experience with Sniffle 00:36:03 Personalized Diet Plans Using AI Technology 00:45:36 Virtual Healthcare Network for Behavioral Wellness 00:57:07 The Future of Sniffle 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:  #Entrepreneurship #HealthcareChallenges #AIHealthcare #TelehealthInnovation #VirtualCare #AIIntegration #PrescriptionProcess #BehavioralHealth #EmployeeBenefits #ResilienceInBusiness #ContinuityOfCare #MentalHealthAwareness #selffunded #podcast Entrepreneurship, Healthcare Challenges, AI Healthcare, Telehealth Innovation, Virtual Care, AI Integration, Prescription Process, Behavioral Health, Employee Benefits, Resilience In Business, Continuity Of Care, Mental Health Awareness, self funded, podcast

Does bone-on-bone contact always lead to pain? What's the best way to get good, new solutions in the hands of brokers? How many MSK surgeries are really necessary? Chris Hamilton, Heidi Ojha, and Mark Testa joined me in studio to answer those questions and many more in this special bonus episode of Self-Funded with Spencer, The MSK Roundtable. 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/

"I always knew there was more. I always knew there was a different dimension to what this personnel or HR thing was." - Monica Panetta Monica Panetta, Chief People Officer at ParetoHealth (a show sponsor and the company I work for), joined me for an evening podcast in studio as we talked all things HR/People, starting with why the industry has moved away from saying HR. Monica’s so well-versed in the field that she actually started the HR program at her college as she was attending it, and the curriculum is still taught today. We talk how she got started in the field, how the field has evolved post-COVID, and how she made her way to Pareto. Join us this week to find out a bit about Pareto, and a lot about what it means to be a Chief People Officer. Chapters: 00:00:00 Meet Monica Panetta 00:01:38 Employee-Centric Leadership: How HR Has Evolved 00:02:38 Transitioning From “HR” to “People” 00:05:00 Getting Started In HR 00:13:16 Monica’s Career Journey 00:21:31 Strategic Benefits Management As An HR Employee 00:23:31 Empowering Employees Through Mental Health Support Programs 00:24:32 Promoting The EAP Program Internally 00:40:13 Recognizing Every Employee’s Journey 00:41:39 Cultural Compatibility Evaluation In The Hiring Process 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: #ChiefPeopleOfficer #HRterminology #CareerExploration #FinancialAcumen #EmployeeAssistancePrograms #UtilizationStrategies #EmployeeExperience #Onboarding #CultureFitAssessment #HRroles #WorkplaceWellness #JobSatisfaction #selffunded #podcast Chief People Officer, HR terminology, Career Exploration, Financial Acumen, Employee Assistance Programs, Utilization Strategies, Employee Experience, Onboarding, Culture Fit Assessment, HR roles, Workplace Wellness, Job Satisfaction, self funded, podcast

 "I think the more questions the employer asks, and just the deeper that they're willing to think about this and have already thought about it, the more they're able to buy into this mission." - Russell Pekala Russell Pekala, co-founder of Yuzu Health, joined me in studio for this week’s episode focused on controlling pharmacy costs and emergency claims.  Yuzu Health is a startup in the TPA space aiming to change how the claims process work. Rather than having the member get care and then deal with lowering costs after the fact, Yuzu pre-adjucates claims when possible, issuing a credit card to members to pay for care and avoiding huge bills on the backend.  In addition to the claims talk, Russell and I chatted about his Harvard days, what founding a dating app was like, and the ramen-related health accident that pushed Russell into the healthcare startup space.  Chapters: 0:00 - Meet Russell Pekala 5:53 - Working On A Dating App At Harvard 08:26 - The Art and Science of Stop Loss Insurance 18:47 - Yuzu's Innovative Startup Health Insurance Solution 20:44 - How Did Yuzu Get Started? 21:45 - Improving Healthcare Transparency and Accessibility with Yuzu 28:48 - Navigating Pharmacy Costs with SmithRX 32:51 - Revolutionizing Emergency Claims in Healthcare 39:26 - Employers Seeking Alternative Healthcare Approaches 54:26 - Revolutionizing healthcare through predictive wearables 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 #healthinsurance #startups #technology #costcontrol #pharmacy #employers #predictivedata #wearables #futureofinsurance #selffunded #podcast healthcare, health insurance, startups, technology, cost control, pharmacy, employers, predictive data, wearables, future of insurance, self funded, podcast

“To me, a private equity firm should never look at a healthcare vertical and say, God, there's opportunity there. That means that there's profit exploitation to be had in those areas.” - Taylor Rogers Taylor Rogers, former professional baseball pitcher turned insurance consultant, joined me this week for a podcast focused on profit exploitation in the current healthcare system, and what we need to do as an industry to bring back competition and lower prices.  There are a huge number of people in this space who used to be college or professional athletes, so I was excited to hear what led to Taylor’s baseball career and what also led him to insurance.  Competition is an inherent component of capitalism, one that leads companies to try to lower prices as much as they can to appeal to consumers, but it’s incredibly absent from this field. Join Taylor and I this week on Self Funded as we try to figure out why.  Chapters: 0:00 - Meet Taylor 07:38 - Consistency, in Baseball and Comedy 09:36 - The Importance of Failure in Growth 12:50 - The Evolution of Insurance Consulting Strategies 18:00 - bridging the gap with accessible communication 23:28 - Navigating Risk Management Challenges in Insurance 25:01 - Guiding employees through the healthcare system 31:26 - Limitations of 24/7 emergency care navigation 35:16 - Strategic guidance and business acumen in consulting 46:29 - The Potential of Direct Primary Care 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:  #insurance #healthcare #consulting #businessstrategy #privateequity #affordablehealthcare #riskmanagement #selffunding #carenavigation #consultingpractice #podcast #selffunded insurance, healthcare, consulting, business strategy, private equity, affordable healthcare, risk management, self funding, care navigation, consulting practice, podcast, self funded

“You can have the same provider, same treatment, two different locations, different outcomes.” - Gentry Lynn Gentry Lynn, VP at Healthcare Bluebook, joined me this week to discuss what it means to actually make an impact in this industry, why there’s so much cost variance between locations, and how we can more effectively engage members to use new solutions. One of the key points of our discussion was that there are actual health outcome and cost ramifications to which location patients get their care from, even if the provider is exactly the same.  The impact of what we do is a frequent topic of this podcast, and in this episode we dive deep into what it means to try to make positive change in such a huge and frequently old-fashioned industry. Chapters: 0:00 - Meet Gentry 02:49 - Gentry Lynn's Journey into the Insurance Industry 19:24 - Remote Collaboration and Specialization in Our Industry 23:19 - Healthcare Cost and Quality Transparency Tool 31:19 - The Impact of Medical Cost Transparency 37:18 - Evaluating Doctors for Optimal Medical Care 46:11 - Cost Variance By Location 51:59 - Personalized Communication leads to Member Engagement 54:05 - Surprising Disparities in Healthcare Procedure Costs 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:  #healthinsurance #healthcare #bluebook #employersolutions #costandquality #centersofexcellence #employermindsets #dataintegration #claimvalidation #costvariance #podcast #selffunded health insurance, healthcare, bluebook, employer solutions, cost and quality, centers of excellence, employer mindsets, data integration, claim validation, cost variance, podcast, self funded

“It's like the Wizard of Oz, I think, or The Matrix. You have this veil that as the participant in it for so long, you just don't think about your benefits. But I think when you kind of peel back the curtain and you're looking at the greed of it and how everyone is getting paid on people being sick, it's gross. And I don't vibe with it.” - Durrell Finch Anyone who listens to the show should know by now that I’m a huge proponent of personal wellness, healthy eating, and exercise, which is why I was super excited to have Durrell Finch join me for this week’s episode.  Durrell is a former fitness trainer and the VP of Business Development for BioCoach, a company focusing on employee wellness through end-to-end obesity and diabetes care and prevention.  We discussed some simple and practical ways to better structure workouts, then jumped into our main topic: GLP-1s, the new class of weight loss drugs, and how employers should assess their role in wellness. Join Durrell and I on this week’s wellness-focused episode of Self Funded, and stick to the end to see if I can properly stand up from a criss-cross position! Chapters: 0:00 - Meet Durrell 04:52 - The Healing Power of Movement 16:49 - Improving Performance through Mindfulness and Biomechanics 17:40 - Navigating Covid Challenges As A Fitness Trainer 30:46 - Biocoach: Data-driven Wellness with Personalized Support 38:05 - Fostering Camaraderie and Personal Growth in the Workplace 42:01 - Affordable and Accessible Healthy Eating Strategies 48:50 - The Role of Muscle in Long-Term Weight Loss 51:06 - Promoting Sustainable Weight Loss through Education 53:28 - Structured Weight Loss Program with Drug Progression 58:12 - Financial Implications of Healthcare Choices 01:06:50 - Revolutionizing Health and Wellness with Fitness Tracking 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:  #ozempic #weightlossdrugs #movement #exercise #wellness #health #fitness #psychology #personalgrowth #mobility #legstrength #biocoach #healing #selffunded #podcast Ozempic, Weight Loss Drugs, Movement, Exercise, Wellness, health, fitness, psychology, personal growth, mobility, leg strength, biocoach, healing, self funded, podcast

"Compliance does not have to be a burden. It doesn't have to be hard. It can be a value differentiator and an opportunity to really help people." - Jen Berman Jen Berman joined me this week to close out our trilogy of compliance episodes. We focused on why regulations exist, the purpose of recent legislation like the CAA, and why it’s important for consultants to learn the compliance process. Jen is the CEO of MZQ Consulting (not an acronym, as we discuss in the episode), a leading provider of compliance solutions in the industry. Recent compliance has shifted the burden onto employers to make sure their plans are compliant, including making sure that their mental healthcare is in parity with normal healthcare.  As Jen said on the episode, compliance is typically viewed as a burden, but for consultants, it shouldn’t be: it’s an opportunity to differentiate yourself in the market and provide a next level of service to employers. Join Jen and I this week for another compliance-focused episode of Self-Funded. Chapters: 0:00 - Meet Jen 2:23 - The Impact of ACA on Healthcare Industry 17:24 - Anticipating Gag Clauses: CAA Compliance Solutions 19:43 - Mental Health Care Should Equal Health Care 27:02 - Employer Investigations 36:23 - Tracking Money Flow and Compliance 41:57 - Gag Clauses and Restricted Access to Plan Information 49:22 - The influential role of compliance professionals 54:53 - The importance of regulatory schemes 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:  #ACA #CAA #healthcare #compliance #regulations #AffordableCareAct #mentalhealthparity #governmentinvestigation #prescriptiondrugdata #gagclauses #complianceprofessionals #selffunded #podcast ACA, CAA, healthcare, compliance, regulations, Affordable Care Act, mental health parity, government investigation, prescription drug data, gag clauses, compliance professionals, self funded, podcast

"When consumers understand that they can get the same level of care at half the price, they feel good about making that decision." - Josh Schreiner “We're actually going to collapse that concept entirely. Everyone's in network from your perspective, from the consumer, from the patient perspective." - Michael Mather Continuing from last week’s theme of compliance and regulation, Josh Schreiner, Chief Product Officer, and Michael Mather, General Counsel, of HealthEZ joined me for a discussion on the effects of the No Surprises Act on the healthcare industry as a whole, and how it affects consultants as they work with employers. At HealthEZ, Josh and Michael have been looking ahead to the future of healthcare and how the recent regulations have impacted that, including a returned focus to consumer decisions in their own healthcare and an increased focus on employer compliance. For consultants, these are particularly important topics as consultant responsibilities shift in response to the legislation. Join Josh, Michael, and I as we break down the No Surprises Act, offering our insights and hopefully some practical guidance on navigating this crucial piece of healthcare legislation. Chapters: 0:00 - Meet Josh & Michael 1:23 - Empowering Consumer Decisions through Healthcare Transparency 5:44 - Navigating Healthcare Compliance 16:22 - Protecting Patients Through The No Surprises Act 23:19 - The High Volume of Disputes 30:39 - Increasing contract disputes impacting healthcare reimbursement 38:05 - Transparent Healthcare Information 40:50 - The Impact of Transparent Healthcare Pricing 50:30 - Gag Clause Attestation and Compliance Challenges 58:34 - Balancing Guidelines and Innovation in Healthcare 1:04:55 - Leveraging Wearables and Data for Personalized 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: #healthcare #transparency #compliance #innovation #selffunded #medicalcosts #consumerinformation #futureofhealthcare #wearables #datadriven #nosurprisesact #regulation #podcast Healthcare, Transparency, Compliance, Innovation, Self Funded, Medical Costs, Consumer Information, Future Of Healthcare, Wearables, Data Driven, No Surprises Act, Regulation, Podcast

“The CAA was the most significant piece of healthcare legislation that we've had since the ACA.” - Sarah Borders Healthcare compliance, especially post-CAA, can be a complex thing for employers to navigate. There’s an increased level of scrutiny on employers, with heavy fees for those who don’t comply.  This week on Self-Funded with Spencer I’m joined by Sarah Borders, co-founder of Benefits Compliance Solutions. Here are a few key takeaways for consultants: Understanding compliance: Navigating the complex regulations and avoid costly mistakes. Turning compliance into an advantage: Discover how you as a consultant can leverage compliance as a prospecting tool, saving clients from lawsuits, penalties, and headaches. Embracing the benefits of regulation: Understand the purpose of the CAA and how it exposes bad practices, ultimately improving healthcare for everyone. Join us this week on Self-Funded with Spencer to learn how to not get sued. Chapters: 0:00 - Meet Sarah Borders 6:37 - Sarah’s Journey To Compliance Expertise 14:05 - The Shift Towards Data-Driven Compliance 17:33 - Remote Work As An Entrepreneur 27:01 - Effective Communication = Effective Information 34:57 - Legal Repercussions Of Cobra Compliance 41:34 - Group Health Plan Compliance 46:20 - Yearly Attestation 54:04 - The Impact Of Regulations On Transparency 1:01:21 - Empowering Clients and Consultants 1:04:38 - The Impact Of CAA On Group Health Plans 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:  #insurance #compliance #industrytrends #ACA #caa #levelfundedplans #Cobra #CobraCompliance #grouphealthplan #ConsolidatedAppropriationsAct #attestation #regulations #consulting #futureofcompliance #healthcarecompliance #selffunded #selffunding #podcast Insurance, Compliance, Industry Trends, ACA, CAA, Cobra, Cobra Compliance, Group Health Plan, Consolidated Appropriations Act, Attestation, Regulations, Consulting, Future Of Compliance, Healthcare Compliance, Self Funded, Self Funding, Podcast