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The Benefits Playbook

Latest episodes

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Oct 15, 2024 • 53min

The Healthcare Consumer Awakening & Digital Health with Ali Diab & Halle Tecco, Collective Health

Ali Diab, CEO of Collective Health, and Halle Tecco, entrepreneur and educator, discuss the urgent need for a consumer-focused approach in healthcare. They share insights on how AI can transform member experiences while emphasizing the importance of personal interaction in healthcare services. Together, they explore the value of public-private partnerships in reducing healthcare costs and advocate for empowering consumers and employers to demand greater accountability within the system.
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Sep 10, 2024 • 39min

Understanding Healthcare's Flaws and Finding Solutions with Michael Menerey, SVP of Alliant Insurance Services

Michael Menerey, Senior VP at Alliant Insurance Services, shares his insights on the flaws of the traditional healthcare system. He discusses the critical need for price transparency and quality metrics, emphasizing that employers and employees must advocate for change. The conversation shifts to the advantages of self-funded health plans, highlighting their potential to control costs and improve care quality. Menerey also stresses the importance of tailored communication strategies to cater to diverse workforce demographics, ultimately enhancing the member experience.
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Aug 20, 2024 • 34min

TPA: The Quarterback of Self-Funded Plans with Brian Olsen, Partner, Employee Benefits at Sterling Seacrest Pritchard

This episode features an interview with Brian Olsen, Partner of Employee Benefits at Sterling Seacrest Pritchard. Brian is an experienced Client Advisor specializing in creative employee benefits strategies to mitigate risks of health plans for companies ranging from 50 to 5,000 employees. His expertise resides in data management solutions and analysis, pharmacy cost containment, and complex contract negotiations. In this episode, Sasha and Brian discuss the intricacies of working in the TPA space, the importance of clinical data in managing healthcare costs, and how to advise clients on network selection, PBMs, and stop-loss insurance strategies.-------“The TPA is the quarterback for a client's self-funded plan. Pulling together all the different players: the PBM, the stop-loss, the broker, the client. Making sure everybody is working as one to execute the plan for the self-funded health benefits. The biggest benefit is a client's flexibility as they're coming to design that game plan. What kind of network do we want to use? How do we want to pay certain types of claims?” – Brian Olsen-------Episode Timestamps:*(01:40): Brian’s career journey  *(05:49): Understanding the TPA model*(12:42): Pharmacy benefit management insights*(18:02): Non-ERISA business and transition challenges *(26:27): Importance of clinical data insights*(30:07): Brian’s advice for those new to the industry-------Links:Connect with Brian on LinkedInEmail BrianConnect with Sasha on LinkedInLearn more about Collective Health
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Jul 30, 2024 • 38min

One Size Doesn't Fit All in Benefits with Kristen Jordan, Benefits & Wellness Manager at Chime

This episode features an interview with Kristen Jordan, Benefits and Wellness Manager at Chime. She is responsible for the development, implementation, and maintenance of various programs that enhance employee well-being and satisfaction. Kristen has a proven track record for designing and managing benefit plans, wellness initiatives, and vendor relationships that align with the company's vision and values.In this episode, Sasha sits down with Kristen to discuss the importance of benefits education, customized wellness programs, and the impact of a leave of absence management tool.-------“When we think about wellness programs, you really do have to tailor them to your specific company. You can't just put a one-size-fits-all program in there because you may not see the results or the engagement that you're looking for when it comes to implementing a wellness program.” – Kristen Jordan-------Episode Timestamps:*(01:21): Kristen’s career journey  *(04:29): Wellness and benefits at Chime *(14:16): How Chime supports employees *(18:21): How Chime builds each year’s benefits plan *(24:09): Ensuring a great member experience*(33:00): Kristen’s advice for those new to the industry-------Links:Connect with Kristen on LinkedInLearn more about ChimeConnect with Sasha on LinkedInLearn more about Collective Health
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Jul 9, 2024 • 55min

Strategies for Managing Pharmacy, Gene Therapy, & GLP-1s with Doug Ramsthel & Jaclyn Rielly, Burnham Benefits

This episode features an interview with Doug Ramsthel and Jaclyn Rielly of Burnham Benefits. Doug serves as the Executive Vice President and Partner of Employee Benefits, and Jaclyn is the Vice President of the Irvine Office. In this episode, Sasha, Doug, and Jaclyn discuss how the shift in pharmacy is affecting employers and members, the rising trend of GLP-1s, and why covering gene therapy drugs is important.-------“If I can convert somebody from a drug where I'm getting a $382 rebate to a cheaper drug where my net cost is a lot lower, that's a better benefit strategy. The only way to do that, in my opinion, is to take control as an employer. Self-fund and be able to start hitting these control buttons that will customize the plan, so you're focusing on the right things. Whereas the PBMs could be focusing just on their rebates because they're getting a slice of it. That's how they make their money.” – Doug Ramsthel“Employers are really starting to get creative when it comes to managing their drug spend, and they have to, while focusing on different financial factors, as well as member behavior, when it comes to controlling costs. As plan costs for prescription drugs increase, member costs typically follow suit, whether it be through increases in cost sharing or premium contributions. With over 70% of office visits and hospital visits involving drug therapy, the rising costs of pharmacy are becoming more and more visible at the member level. I think the biggest shift, though, in pharmacy affecting members today really is that of access and affordability.” – Jaclyn Rielly-------Episode Timestamps:*(01:13): How the shift in pharmacy is affecting employers and members*(16:18): Doug discusses his book and obesity treatments *(19:46): Doug dives into GLP-1s *(33:08): Jaclyn discusses gene therapy drugs *(45:50): Jaclyn explains the value-based formulary idea  *(49:40): Final thoughts on gene therapy drugs and GLP-1s-------Links:Connect with Doug on LinkedInConnect with Jaclyn on LinkedInConnect with Sasha on LinkedInLearn more about Collective Health
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Jun 18, 2024 • 39min

Innovative Solutions for Mental Health & Addiction Treatment with Dr. Smita Das, VP of Psychiatry & Complex Care at Lyra Health

This episode features an interview with Dr. Smita Das, Vice President of Psychiatry and Complex Care at Lyra Health. Smita is board certified in psychiatry, addiction psychiatry, and addiction medicine and has over 20 years of research experience. Previously, she served as President of an American Psychiatric Association District Branch and chair of the APA's Council on Addiction Psychiatry. Smita is also a clinical associate professor of Psychiatry and Behavioral Sciences at Stanford School of Medicine.In this episode, Sasha and Smita dive into Lyra Health’s Complex Care Program, how the conversation around sobriety is changing, and how addiction and mental health psychiatry differ and intertwine.-------“There's so many places where somebody can fall through the cracks, for one reason or another. It could be coverage. It could be that they couldn't find a facility or that there were too many options and they had analysis paralysis, or they went to a place that wasn't actually evidence-based or at the bar that we expect at Lyra. Then, they're actually worse off because now maybe they've paid out of pocket tens of thousands of dollars and they didn't actually get better.” – Dr. Smita Das-------Episode Timestamps:*(01:28): Smita’s career background *(05:25): Why point solution access is important *(09:15): Smita explains Lyra Complex Care*(23:50): How addiction and mental health psychiatry differ and intertwine*(29:15): Examples of employers who have accessible recovery programs*(33:12): Smita’s advice for employers looking into complex care-------Links:Connect with Dr. Das on LinkedInLearn more about Lyra HealthVisit Rethinking DrinkingVisit SAMHSAVisit AtlasVisit FindhelpVisit NAMIConnect with Sasha on LinkedInLearn more about Collective Health
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May 28, 2024 • 43min

Empowering Members to Make Better Care Choices with Dr. Matt Resnick, Chief Medical Officer at Embold Health

This episode features an interview with Dr. Matt Resnick, Chief Medical Officer at Embold Health. He is a member of the founding executive team and led the development of measurement and analytic stacks. Today, he is responsible for growth and all go-to-market functions, leading a team in developing strategy and building products that align with market demands and deliver exceptional value.In this episode, Sasha sits down with Matt to discuss the importance of quality care measurement, how it can benefit both employees and employers, and how measurement tools change based on patient age.-------“All of us spend countless hours, minutes researching all of the relatively superfluous purchases we make, like on Amazon. Yet, when it comes to finding a doctor, we trust our neighbors. The reality is most of us like our doctors and most of us don't have enough knowledge to know whether what we did was the right or the wrong thing. Even people who have bad outcomes actually like their doctors. The reality is we know if you walk in door A or door B, your likelihood of winding up on an operating table in a year with back pain is tenfold different.” – Matt Resnick-------Episode Timestamps:*(01:15): Matt’s career background *(07:18): Why quality care measurement is important *(19:00): How Embold helps members find quality providers *(29:49): How quality care measurement helps employers *(34:04): How measurement tools change based on patient age-------Links:Connect with Matt on LinkedInLearn more about Embold HealthConnect with Sasha on LinkedInLearn more about Collective Health
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May 7, 2024 • 44min

Navigating the Shift to Self-Funded Health Plans with Dan Hodges, SVP of Employee Benefits at Woodruff Sawyer

This episode features an interview with Dan Hodges, Senior Vice President of Employee Benefits at Woodruff Sawyer, where he provides strategic consultation and counseling to clients on their employee benefits programs. Dan has over 25 years of experience consulting a large cross section of employers including those in healthcare, not-for-profit, high-tech, service, and hospitality. He is also an expert in self-funding, consumerism, and HSA style plans.In this episode, Sasha and Dan discuss transitioning to self-funded health plans, choosing a TPA versus an ASO, and the future of employer benefits.-------“You also have a lot more flexibility just on how you design your program. The different pieces that are baked into a fully insured program, how you can break those out, how you can go to specialty markets and get either better service or lower cost for that part of your program. How you can get better programs for your employees to take advantage of within a self-insured program. There's a lot of flexibility that you get, both in terms of service to the employer, service to the employee, and cost savings to the company.” – Dan Hodges-------Episode Timestamps:*(01:22): Dan’s career background *(06:33): Dan breaks down transitioning to self-funded health plans*(23:25): Choosing a TPA versus ASO*(26:00): Woodruff Sawyer’s unique offering*(34:32): The future of employer benefits*(36:52): Dan’s advice for people new to the industry-------Links:Connect with Dan on LinkedInLearn more about Woodruff SawyerConnect with Sasha on LinkedInLearn more about Collective Health
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Apr 16, 2024 • 46min

Pharmacogenomics and Personalized Pharmacy Care with Jessica Lea, Founder & CEO of Tria Health

This episode features an interview with Jessica Lea, founder and CEO of Tria Health. Jessica is passionate about pharmacists providing patient-centered care to improve the health outcomes of patients. She has a Doctor of Pharmacy degree from the University of Missouri-Kansas City, maintains board certification in psychiatric pharmacy, and has an Executive Masters in Business from Rockhurst University. Jessica is a healthcare innovator and has been recognized as one of the PharmaVOICE100.In this episode, Sasha sits down with Jessica to discuss the revolutionary study of pharmacogenomics, the craze around weight loss drugs, and how Tria Health supports its members.-------“We're starting to get to a place where we have a better understanding of more medications that we know are affected by the way in which your body may metabolize or not metabolize the medicine, as it relates specifically to your DNA. The other thing is that not only have we gained more understanding of more medications, but we've also gotten to a place where it's a little more cost-effective in testing the right people who we believe would benefit from this.” – Jessica Lea-------Episode Timestamps:*(01:24): Jessica’s career background *(04:31): How Tria Health supports members*(14:51): Jessica dives into pharmacogenomics*(27:50): How pharmacy and medical interact *(32:07): Jessica’s thoughts on weight loss drugs*(41:32): Jessica’s advice for those starting their own businesses-------Links:Learn more about Tria HealthFollow Tria Health on LinkedInConnect with Jessica on LinkedInConnect with Sasha on LinkedInLearn more about Collective Health
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Mar 26, 2024 • 40min

The Basics of Healthcare with Michael Caussin, Licensed Health Advisor

This episode features an interview with Michael Caussin, former NFL tight end and New York Times bestselling author. Mike became a licensed health advisor in 2023 and helps individuals and families find the health coverage they need.In this episode, Sasha and Mike get back to the basics of healthcare. They discuss why healthcare education is so important, how to navigate life events, and what people don’t know about coverage options.-------“I want to be an asset to people in whatever I'm doing in my life. Let me teach everyone that's watching or following the simple basics of your day-to-day coverage. I've gotten much more positive feedback than I ever imagined of people commenting or messaging me on how helpful it's been. Which obviously for anyone, it's validating to get that reassurance that you're actually helping somebody.” – Michael Caussin-------Episode Timestamps:*(01:15): Mike’s career background *(07:27): How Mike uses his Instagram to educate people*(11:45): Mike’s advising process*(18:49): How Mike helps people navigate life events*(27:24): How Mike improves member experience*(32:48): Mike’s advice for those new to the industry-------Links:Follow Mike on InstagramConnect with Mike on LinkedInConnect with Sasha on LinkedInLearn more about Collective Health

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