Voices of Self Funding

In this episode, Ramesh interviews Matthew Albright, Chief Legal Officer at Zelis, who has been involved in various healthcare regulatory issues, having worked at CMS. In this podcast episode, we will answer key questions such as what is the intent of price transparency regulation? What are the key requirements that TPAs and Employers need to worry about? What is the simplified version to worry about? And finally, what are the recommended steps to take? This episode was sponsored by WEX. For more information on price transparency or other topics related to the self-funding industry, please visit HCAA.org.

In this episode, Ramesh interviews Dallas Scrip, CEO of Benefit Management LLC from Wichita, KS, and Ashok Subramanian, CEO of Centivo, from Buffalo, NY. This episode dives into questions about the challenges TPAs face in competing against BUCA carriers, what investments TPAs need to make, and what the advantages TPAs have in their business model. (Please Note: The episode was recorded before the Buffalo Bills game against Kansas Chiefs in the Superbowl.) This episode was sponsored by Optum Rx. For more information on competing against the BUCAs or other topics related to the self-funding industry, please visit HCAA.org.

In this episode, Ramesh interviews Dr. Keith Smith, founder of the Surgery Center of OK, one of the pioneering firms that have published their fixed prices down to the dollar for surgeries for more than 10 years. This podcast episode will touch on what a specialized surgery network means, what type of surgeries can be directly steered to specialized centers, what kind of savings to expect, and whether or not quality and cost are better at these specialized surgery centers. This episode was sponsored by ECHO Health. For more information on surgery networks or other topics related to the self-funding industry, please visit HCAA.org.

In this episode, Ramesh talks with Brian Klepper, an expert, and consultant on contracting to create high-performance provider contracts. The podcast will answer questions like: What are the issues with the way providers deliver care or programs, which category of services can employers put in outcome-based/high-performance contracts, what data is needed to contract and manage these outcome-based initiatives, how to go about seeking these contracts.   This episode was sponsored by ELAP. For more information on creating high performing networks or other topics related to the self-funding industry, please visit HCAA.org.

In this episode, Ramesh talks with Ernie Clevenger, someone who has dedicated his entire entrepreneurial career to bringing better care, managing risks and leveraging healthcare technology. He is founder of CareHere, a successful worksite clinic, now part of Premise Health. Ernie also runs and distributes MyHealthGuide, a newsletter bringing latest developments in the self-insured employer space. Today's podcast will answer questions pertaining to different models of operations like worksite clinics to direct on-site primary care models, what are the pricing models, what are the emerging trends, how is virtual primary care competing with direct primary care model, and what is the role of data to support these disparate models. This episode was sponsored by Deerwalk. For more information on direct provider contracts or other topics related to the self-funding industry, please visit HCAA.org.

Honest discussion on Reference Based Price with Steve Rasnick: Steve is a veteran of the TPA space, having built and sold multiple TPA businesses, and more importantly a strong believer in the value of bringing innovation and better solutions to the self-insured employer industry. Today's podcast will answer questions about where RBP works, who is the right employer, what happens to the employee and provider relations, is it worth it, what are the steps to take to make RBP effective? We’ll also examine what can you do to improve patient education/advocacy, and what are still some of the challenges involved in selling and supporting RBP? This episode was sponsored by MedWatch. For more information on RPB or other topics related to the self-funding industry, please visit HCAA.org.

Virtual Primary Care of the future: We interviewed Paul Kowalski, one of the early enthusiasts of telemedicine, and currently VP & GM at Teledoc Health. Today's podcast will answer key questions about telemedicine, whether it is a affordable alternative to various healthcare needs, the value offer for the consumer and employer, and the transition from episodic care to continum care. And, we'll discuss the vision for virtual primary care, and perhaps some of the challenges along the way. This episode was sponsored by DataPath. For more information on Virtual Primary Care or other topics related to the self-funding industry, please visit HCAA.org.