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In this episode, Michael interviews Nate Murray, the Chief Business Development Officer at Crossover Health. Crossover Health is a national primary care medical group that connects employees with remarkable care options while helping employers take control of their healthcare spend. In this episode, you’ll hear about some of the deficiencies in primary care today and why many large employers have started to engage in direct contracts with providers to offer improved primary care to their employees. Tune in to hear about the evolution of the Crossover Health primary care model and how they are using a team based approach to deliver extraordinary care for their members.Here’s a glance at what you’ll learn from Nate in this episode: What the Health 2.0 movement is and where it’s going.Why rushed doctor visits equate to poor healthcare and how this impacts costsHow deals with Apple, Facebook and Amazon helped Crossover Health design a primary health model.How Crossover Health creates a relationship between patients and doctorsHow integrating behavioral health and physical therapy into the Crossover model impacts patient careHow effective primary care can help companies reduce their downstream costs.Timestamps:0:22 – Introducing Nate and Crossover Health2:55 – How Nate got into healthcare4:38 – Nate’s wife having rheumatoid arthritis exposed the inability between what insurance companies were capable of compared to doctors.7:16 – It’s less about the health insurance, and it’s more about the quality of healthcare that’s having an impact on costs.8:12 – The Primary Care Crisis: Primary Care is the speedbump to the expensive healthcare industry.11:20 – The system is lowering the quality of care. Doctors can’t provide quality if they’re seeing 30 patients a day.14:48 – Crossover Health: How they transitioned into focusing on primary care by securing a deal with Apple.18:00 – The Foundation of Primary Health: How Crossover is able to provide virtual primary care in all 50 states.19:00 – The Triple Aim:QualityExperienceOutcome22:20 – Integrated Care Teams: How to analyze what a patient needs and then deploy a team to create the outcomes needed.26:00 – Creating “Touch Points” with a patient: “Regular” is about having a relationship with a patient, rather than infrequent check-ups. 30:00 – Sherpaa Acquisition: How Crossover is acquiring companies to help deliver their triple aim. 32:00 – Creating a new offering with virtual primary care34:12 – How did COVID-19 impact the utilization of virtual primary care?: “We could still operate and serve patients remotely.” 35:40 – Reaching out to 100,000 members to ensure they had care during COVID-19.37:50 – Primary Care Doctors went above and beyond during COVID: “They were in it for the right reasons and didn’t turn away patients.”38:34 – Crossover Pricing Studies: How the economics of primary care help companies reduce their downstream costs.44:08 – The goal is to allow our patients to create trust with our recommended doctors. 45:24 – How Crossover bills for its services46:35 – ‘Fee for Service’ creates an environment to rush patient visits. Crossover is strongly against fee for service. 47:39 – Implementing a value-based cap to dissuade overbilling.51:40 – Patient Experience: How Crossover got a Net Promoter Score north of 90.54:04 – Employers need to take a step back and consider “how can my employees trust our healthcare service?”55:08 – ConclusionResources:Crossover Health Website: https://crossoverhealth.com/Nate Murray’s LinkedIn: https://www.linkedin.com/in/nathanlmurray/

In this episode, Michael moderates a webinar that highlights an employer who took action to help their employees find higher quality, more cost-effective care. The episode highlights two panelists, one with Christin Deacon, the Assistant Director of the New Jersey State Health Plans, and the second with David Vivero, the Co-Founder and CEO of Amino. Christin is a healthcare leader and public sector entrepreneur. She is a former deputy attorney general and private sector restructuring attorney, and her unique background allows her to have a different perspective on the status quo in the realm of healthcare. She engaged with Amino to get ahold of out-of-network spend and make an impact on the trajectory of cost in New Jersey, which is $2B on pharmacy and $5B on medical and growing. When David Vivero spoke with Christin and learned the needs of the state and its members, he learned that staying within the network and better hospital selection were primary concerns. Employers and employees were having trouble finding cost-effective care, and he knew Amino’s platform could solve for that. The state was able to move fast and implement Amino in just eight months, and their first push was the digital experience and matching people with the right provider and tools. David explains that the goal was to solve the three fundamental problems of healthcare guidance: providing the data to inform a good decision, creating an experience that delivers results, and distributing it effectively. The Amino Smart Match label finds the high-performance network by stratifying the network by cost, quality, experience, and appropriateness, and their Integrated Benefits Tool connects the dots in the healthcare system so members cut through the noise and find exactly what they need. Amino is all about “Getting back to it.” They understand that people don’t want to be experts in healthcare and just want to be healthy with the support of quality, cost-effective care. And with an NPS score of over 80, it’s working. On the horizon, Christian sees more engagement in digital health, a spike in telemedicine, new models of delivery, and more opportunities for education. As for Amino, they have an exciting road ahead. They’re following trends in the market, working towards ER avoidance, and getting into retail clinics. Here’s a glance at what we discuss in this episode: 00:30 - Introducing the panelists and discussion.03:00 – Christin’s unique background, burnout, and draw to public service. 04:15 – The division of pensions and benefits and the health benefits climate in 2018.05:10 – Status quo, out-of-network spending, and getting ahold of cost and spend. 05:50 – The trajectory of cost: $2B of pharmacy, $5B on medical and growing.6:35 – One or two large claimants can make or break a year; you can’t assume someone is watching every dollar with such a large plan. 07:00 – Her interest in Amino; she listens to podcasts, including the Reconstructing Health podcast, and heard the interview with David Vivero.07:45 – David’s first conversation with Christin and how the Amino solution can benefit the state. 08:15 – The first few conversations were about learning the needs of the state and its members, specifically, staying in-network vs. out and hospital selection. 10:05 – They learned the challenges, stakeholders, and experience and the ways Amino could help. 10:50 – Employers and employees have trouble finding cost-effective care; Amino solves for that. 11:30 – They implement Amino in 8 months; Christin’s first step in moving it forward was the digital experience and matching people with the right providers and tools. 13:25 – They integrated Amino through their carrier to be wherever members go to get their information.14:05 – The obstacles Christin faced when replacing Horizon’s tool with Amino’s.14:25 – There’s general reluctance and lack of trust when there is a loss of control; they were forced to think differently. 15:00 – The fundamental problem of healthcare guidance in 3 layers and how Amino solves for them in a centralized way:15:25 – #1: Do you have the data to inform a good decision?15:45 – #2: Are you able to create an experience that delivers results?16:05 – #3: How does that get distributed?16:30 – Amino’s data already saw discharges, claims, what people are claiming and getting, and referral patterns, patient patterns.  17:20 – The Smart Match Label: Finding the high-performance network by stratifying the network by cost, quality, experience, and appropriateness.18:05 – They are flexible to support any existing platforms. 19:20 – Their unified benefits communication system and central platform have big implications. 20:00 – Quality, communication, and engagement made it a platform member would actually use.22:05 – The Integrated Benefits Tool: The thing that connects the dots in the healthcare ecosystem. 24:00 – People like Christin may work with benefits consultants, but members don’t; they need integrated benefits/tools layered organically in search results. 26:30 – Christin launched Amino in June of 2020, off-cycle to their benefits year; it wasn’t intentional but lent itself to a lot of opportunities. 28:00 – She believes off-cycle launches are important to help people better engage in the healthcare system and move away from the status quo.28:50 – The first six months of product launch: 29:15 – Everyone is digital now; they sent out emails and tied a wellness point program to creating an Amino account as an incentive.30:05 – Their 2021 communications calendar includes educators and is strategic ongoing engagement with micro-populations. 31:30 – What Amino is all about: “Get back to it.”31:30 – None of us want to be experts in healthcare; we just want to be healthy. 32:25 – The goal is to just get people to use it. Their NPS is over 80 and people will come back if they just use it once. 33:30 – Michael’s personal testimonial for Amino.34:50 – People just want to do less in healthcare; it should be a benefit, not a trade-off for members, and it should be about quality, not just cost savings. 35:35 – The variance of quality and cost in healthcare:36:00 – We value choice but we don’t consume a whole network; Amino takes claims data sets and scores them to better guide people to providers. 39:10 – Christin’s learnings with Amino: lots of Musculoskeletal needs, quality delivers on multiple fronts, word-of-mouth is important, member testimonials. 41:05 – What’s on the horizon for Christian: members engaging in digital health, a spike in telemedicine, new models of delivery, opportunities for education. 42:00 – Amino is following the trends in the market, working towards ER avoidance, retail clinics, and backlogging MSK surgeries.43:30 – Amino Refer: Access to intelligence in real-time.  45:50 – The difference between transparency and guidance: They direct to primary care or virtual care when this kind of guidance is needed – they still request referrals. ResourcesAmino

In this episode, Michael interviews Omar Dawood, the Chief Medical Officer and Head of Sales at Calm, the #1 app for sleep, meditation and relaxation. The app has over 100 million downloads and over 1.5M 5-star reviews.Omar is a clinician and stage IV cancer survivor with over 25 years of senior management, medical research and clinical experience, innovating medical devices and digital health products as a senior executive. At Calm, he leads B2B employer and health plan sales and is passionate about helping people around the globe lead healthier, happier lives by building resilience through better sleep and improved mindfulness.While 20% of Americans are dealing with a mental health illness of some sort, Omar believes that we shouldn’t forget about the other 80% of people who experience stress and anxiety without a mental health diagnosis. That’s where Calm comes in to act as a preventative measure to improve behavioral and mental health as well as resilience through mindfulness practices, meditation, and strategies for better sleep. Calm started as a B2C app but is making strides in the B2B sector to support employers, employees, and organizations. And it’s working. The sign-up rate on employer accounts is 30% with 80% engagement, and the experiences it offers – like the “Daily Calm” and “Sleep Story” – are helping employees reduce stress, sleep better, respond better to life, communicate more effectively, and boost immunity around the world. The benefits Calm offers to organizations and employees is clear. For organizations, they provide actionable insights and aggregate trends. For employees, they offer pathways to increased resilience and wellbeing and a “Calm Effect” that touches every area of their life.Calm’s NPS is just over 70 and they do qualitative ratings and satisfaction measurements in a number of ways. The team at Calm is excited for more innovation in behavioral and mental health and encourage collaboration in the field in order to spread health and happiness to billions.  Here’s a glance at what we discuss in this episode: 00:50 - Introducing Omar and Calm. 02:30 – His cancer diagnosis changed his view on medicine and the industry’s lack of data; he didn’t appreciate the value of mental and behavioral health until 10 years ago. 04:45 – He saw a need to bring an engaging experience to behavioral health; this is how he came upon Calm and loves his role in bringing that to employers/employees. 06:30 – The 1 in 5 statistic: Omar believes we should consider the preventative health of the other 80% who also experience stress and anxiety but aren’t diagnosed.08:50 – The pandemic opened up the dialogue that we’re all coping and should do something about it because we’re human, not because we’ve been diagnosed. 10:00 – Most employees experience stress and anxiety; digital health made help easier and more accessible, but still sat downstream in terms of treatment.12:50 – What was missing was something more upstream and preventative.13:00 – EAP services 0-3% engagement, Calm’s sign-up rate is 30% on employer accounts and average engagement of 80%; it’s not seen as behavioral health at all. 14:40 – Calm is an experience, not a product, and becomes a part of the user’s life to support better resilience through meditation, mindfulness, and better sleep. 16:30 – They started with B2C and are now working with employers and organizations to broaden their impact. 18:15 – The benefits of meditation: The “Daily Calm” content through the app helps people respond (not react) to life and communicate better. 21:30 – It impacts your immune system, your ability to support yourself through challenges, and shift your perspective. 23:20 – Narrated mindfulness topics: Gratitude, visualization, positive frameworks, communication.27:00 – Using Calm for better sleep: The “Sleep Story” is a bedtime story told by a narrator of your selection, they now have clinical evidence and studies around it. 30:50 – Calm for Kids: Kids are taught nutrition and exercise early on but should also learn mental and behavioral health skills. 31:40 – It’s best if everyone in the household is on board with healthy habits.32:30 – There is music, a journal, and a mood tracker in Calm; they see what the market wants then are thoughtful about how they develop it. 36:20 – Calm’s value for organizations: For organizations they provide actionable insights and aggregate trends. 37:30 - Calm’s value for employees: Increased access to behavioral health and the “Calm Effect.” 39:40 – Their NPS is just over 70, they do qualitative ratings (app reviews), and measure satisfaction in a number of ways. 40:30 – It resonates across every sector and is benefitting a huge variety of organizations. 42:00 – Engagement is easy; most people have already used Calm, know someone who has, or has heard of it. 42:30 – Calm is for employers who want to help their employees. 43:10 – What’s next: They don’t sit idle and encourage more innovation in behavioral and mental health. ResourcesCalm

In this episode, Michael introduces Justin Leader, the CMO of Highlight Health and a self-funded benefits and risk advisor. Early in his career, Justin learned about the major shortcomings of the healthcare and health insurance industry and how it is built for profitability, not value. When he met Josh Spivak, the CEO of Highlight Health, they saw an opportunity to build a better solution for an underserved segment of the population. Highlight Health’s mission is to deliver affordable and accessible healthcare to the nation’s underinsured populations. Their product is not a health insurance product, but rather a healthcare product where in exchange for a fee, an employer’s underinsured employees get access to healthcare, education, and an advocate. The populations they serve typically don’t work enough hours to qualify for full time benefits, can’t afford their traditional benefits, or may be offered limited MEC or Minimum Value plans that really don’t offer access to comprehensive healthcare.   Highlight Health’s goal is to systemically help people access 80-90% of their basic healthcare needs through their platform and mitigate risk for catastrophic events. Highlight Health differs from other vendors in the market by providing an advocacy service for members and negotiating with Hospitals to provide inpatient and outpatient care at zero or reduced cost through federally-funded programs. Highlight Health is busy collecting feedback and success stories from members and they look forward to a future full of collaborations and philosophically-aligned partnerships to better serve their members. Here’s a glance at what we discuss in this episode: 01:00 - Introducing Justin and Highlight Health. 02:40 - How he got into benefits consulting.05:45 - How he became a part of Highlight Health. 07:50 - The political approach to healthcare and the point that’s missed. 09:00 - There’s tremendous pain when trying to navigate the healthcare system.11:45 - The collective problem in healthcare and the responsibility all must take.12:40 - The working poor and healthcare illiteracy. 14:00 - The difference between health insurance and healthcare. 14:15 - The Highlight Health product; your friend in healthcare. 15:10 - They focus on accessibility and care; advocacy is a cornerstone.16:45 - They provide education and value to empower people to make better decisions. 18:22 - They take regulations and laws and leverage them to access care across the country. 19:30 - This is not a health insurance product, it's a healthcare, capitated product.21:10 - Thoughts on GAP funding. 21:40 - How the drug component of Highlight Health works.24:30 - Highlight Health’s vision for the future. 25:20 - How community-based programs work and how Highlight Health would help a member get care in a selected hospital system. 28:40 - Their goal is to systemically help people access 80-90% of their basic needs through their platform and mitigate risk for catastrophic events.29:25 - They can provide compliance components and supplemental products. 32:00 - The employer’s get a simple, consolidated bill from Highlight Health.33:05 - Employee outreach: They communicate the programs appropriately and offer virtual support. 36:30 - They’re collecting feedback and success stories and are holding big institutions accountable for the community care they’re required to provide. 39:00 - He’s looking forward to getting people excited for something new, collaborations, philosophically-aligned partnerships, and to leave a legacy.ResourcesHighlight HealthLinkedIn

In this episode, Michael introduces Doug Aldeen, a healthcare and ERISA attorney. He has represented reference-based pricing organizations, PPO networks, medium to small self-funded plans, TPA’s and provider sponsored HMO’s in various capacities. Doug started his career at an insurance defense firm, then worked at a local HMO for years. It was there that he learned the ins-and-outs of the healthcare industry and realized that “discounts” aren’t real, but the prevalence and unsustainability of cost-shifting very much are. He found that in many cases there’s no correlation between what hospitals charge and their cost, and “turbo-charging”—where hospitals raise billed charges at unreasonable rates—is common in commercial insurance yet illegal in the Medicare world. Doug has seen “turbo-charging” of 12-24x, and 30x pricing on prescriptions and implants. Surprisingly, employers are often completely unaware of what’s going on under the hood of their healthcare plan. They’re left in the dark because of limited access to data, billing statements without itemized, line-item costs, and “Revenue Neutrality Agreements” that sometimes allow providers to be paid more than they bill. Doug believes commercial insurance plans serve as an ATM for hospitals at the employers and patients expense, all because no one is monitoring, auditing, and demanding to see what’s getting billed, what’s getting paid, and why. And with the employer fiduciary duty under ERISA, this could be a costly oversight for employers that may lead to lawsuits in the future. Doug works primarily with employers who have self-funded plans and reference-based pricing plans. He develops direct contracts with Hospitals and Providers on behalf of employers and their employees. For Doug, a successful agreement with a provider should be simple; only clean claims are paid, all claims are auditable, price is reasonable and there is a benefit incentive for employees to receive care at the facility.  More importantly, a safe harbor has been created where the employee can receive care without having to worry about balance bills which are not allowed under the contract. With his day to day work and advisory position at RIP Medical Debt, Doug is making a positive impact in the healthcare industry and we’re excited to see him keep up the good work. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Doug, a healthcare and ERISA attorney who helps employers and payers offer affordable healthcare to employees and dependents. 02:12 - He’s been a lawyer for 28 years; he worked in an insurance defense firm doing dram shop cases in 1997 and ended up at a local HMO for 7 years.03:30 - The most fundamental flaw in the industry: discounts aren’t real, overpaying, and cost shifting in the commercial market are unsustainable. 05:45 - There’s no relation between what they are charging and their cost; we need honest conversations and common middle ground. 06:30 - Hospital “turbo-charging”: Hospitals charge X and insurance companies match it with the premium; it’s “chumminess” between providers and insurance carriers. 08:35 - Turbo-charging is expressly illegal in the Medicare-world but not the same in the commercial world; you can see this anywhere from 12-24x.09:30 - He’s seen 30x pricing on Rx and implants; CFOs need preservation of P&L and need to get motivated to understand how this all works. 11:00 - Turbo-charging is illegal with Medicare; we can’t vilify healthcare providers, it’s not them.12:40 - Data ownership: Cigna owns the data and allows you to access it on a limited basis; the data should be a part of the plan; you should be able to see bill charges.14:10 - Anthem has a “Revenue Neutrality Agreement” executed on the side with the hospital system - they found 30% of claims were paid more than the billed charges. 16:05 - Employers don’t know if they’re getting what they’re promised without an audit; they don’t even see itemized, line-item billings. 18:30 - Employers, keep an eye out for agreements where providers can be paid more than they actually bill. 19:40 - Health plan transparency regulations were just recently passed.  Insurers must now share cost-sharing estimates at the request of an enrollee and publicly release negotiated rates for in-network providers, including out-of-network allowed amounts, billed charges, and drug price charges.21:15 - Why a commercial plan is an ATM for hospitals; no one is really monitoring the store and there’s nowhere else to really shop. 22:40 - Employer fiduciary duty under ERISA: Similar to fiduciary responsibility with respect to 401Ks23:50 - Employers are fiduciaries to make sure they’re paying a fair price for healthcare on behalf of employees—you can’t do that with “network discount” products. 25:30 - Employees could sue an employer for breach of a fiduciary duty and it happens all the time in the 401K world. 26:00 - Doug’s direct contracting work: He works with employers who have self-funded plans and reference-based pricing plans; he gets hospital financials to see their numbers. 26:50 - By doing this, he sees the cost-shifting that occurs by comparing Medicare and commercial costs. 27:50 - He gets the data and their true costs; it’s all available for those who look and can read it. 28:45 - AGB (Average Gross Bill Charge) is all claims divided by all payments; you need the data to know where the gap is. 30:10 - In some cases, they tell you to go somewhere else; they will not base any contract on a percentage of Medicare. 31:00 - Key components of a successful agreement: Paid consistently, a covered benefit, auditable, clean claims only. 32:15 - Waiving co-pays and having a safe harbor provides the right incentive for employees to stay healthy and get care.34:30 - Hospitals cannot unilaterally charge gross bill charges without first determining eligibility under their financial assistance policies (FAP); this jeopardizes 501R & 501c3.37:55 - Doug’s fee structure: Flat fee + PMPM for 12-18 months. 39:10 - Start with hospital financials to see which ones are healthy; know the competition. 40:05 - RIP Medical Debt: They buy medical debt on the secondary market to forgive people’s medical debt.ResourcesDoug AldeenRIP Medical DebtDoug’s LinkedIn

In this episode, Michael introduces Mike Poelman, the founder and president of Apta Health. Although Mike started his career as an accountant and controller, he quickly realized that he was a salesman at heart so he shifted into the TPA world working on self-funded health plans. This is where he realized that things needed to be done differently. Mike saw that lack of transparency and collusion were the biggest problems in the industry, and legacy solutions simply weren’t designed to provide employers what they needed, which is what inspired him to create a number of companies, including Apta Health.Apta Health aggregates middle market employer groups under one umbrella so they can benefit from care coordination and cost containment solutions that are typically only available to Fortune 500 size companies. This member centric approach allows more effective customer service, higher member engagement by a team of experts/advocates to reduce provider gaps, contain costs, and improve the member journey. In fact, 88% of employees engage with a care coordinator even before a claim enters the system, which is unheard of in the industry. The team at Apta Health has an NPS rating of over 70 for their members, employers, and providers because of their attention to the customer experience first and the TPA second. Apta Health has an exciting future ahead. They’ve recently won the 2020 Health Value Award from the Validation Institute and look forward to continuing their use of analytics and data to empower brokers and employer groups to make easy, cost-effective decisions. Here’s a glance at what we discuss in this episode: 00:45 - Introducing Mike, the founder and president of Apta Health, who is passionate about providing self-insured solutions. 01:05 - Apta Health is a provider of care coordination and cost-containment solutions to optimize self-funded healthcare programs.02:30 - He started as an accountant and controller but is a salesman at heart; when he first started in the industry, all he had was a phone book and phone. 04:05 - He didn’t intend to be a part of a TPA but he knew he wanted to change things by looking from an employer standpoint first. 04:40 - He started Novo Benefits, a platform where employers are empowered to get direct contacts and unbundle their programs. 05:30 - They’ve evolved into an aggregator with Apta Health; they are changing the industry and empowering employer groups. 06:50 - The key issues in the healthcare industry: transparency and collusion.09:00 - What Apta Health does: They aggregate employer groups under one umbrella so they can benefit from large group level pricing, solutions, and engagement. 10:36 - They offer Fortune 500-level engagement to the underserved middle-market. 11:00 - The Quantum care coordination model and how it’s different: more effective disease management, better execution, and functionalities done by one pod.12:30 - Apta is a conglomerate of solutions; they’re getting 200% better engagement 13:50 - The member journey, reduce provider gaps, drive the member experience, and get results and better engagement. 15:47 - A team of experts/nurses help guide and navigate patients through disease management to get them what they need, not just verify coverage. 17:25 - The pod team helps members find more cost-effective solutions they may not know about and create a trusting relationship with members. 21:15 - Stories of above-and-beyond service from the team that is fighting for the member. 22:35 - Deep analytics helps decide what’s best for groups, they use quality metrics, point solutions drive what needs to happen, and an easy number to reach support. 25:15 - Their PCP-centric model helped them avoid wasteful spending; the real-time intercept helps direct members and helps them avoid unnecessary tests. 28:00 - Mike shares his experience with his daughter to illustrate how a navigator can help you avoid certain costs and redundancies. 30:05 - 88% of employees are engaged with real-time intercept/ a care coordinator before claims come into the system - this is unheard of in the industry.31:20 - They promote preventative care and have a care coordinator review paperwork and post-discharge instructions to ensure accuracy. 35:00 - On tracking the consumer experience (The Net Promoter Score): They track the member, employer, and provider and are above 70 across the board. 36:20 - On integrating with a TPA and expanding into other areas; they have something in every category now. 38:05 - The customer experience is first and the TPA is second. 38:45 - Independent analysis shows a 2.9% compounded annual growth rate (compared to the industry 8.5%).39:25 - Rough point solutions drive book-of-business cost reductions across the board. 40:28 - Medical and Rx analytics were sent to the Validation Institute for the Health Value Awards. 41:40 - Other main point solutions of the platform: They have over a dozen that people look to, like Quantum, NavRx, second opinions, and cash pay. 44:00 - Fraud waste and abuse: They have trust accounts to get money back to employer groups.46:35 - The fee structure: A discounted PMPM from Quantum converted to a PEPM.47:10 - Obstacles: The employers say yes more often than the brokers; the biggest thing to overcome is the cost component. 49:05 - The future of Apta Health: Analytics, data, point-and-click things are coming to empower brokers and employer groups to make easy decisions. ResourcesApta Health

In this episode, Michael introduces Dr. Simon Mathews, a distinguished researcher, clinician, author, and Chief Medical Officer at Vivante Health. He is also a practicing gastroenterologist at the John Hopkins School of Medicine and the Head of Clinical Innovation at John Hopkin’s Armstrong Institute of Patient Safety and Quality. Simon’s research centers around understanding and improving the quality of digital health for patients. Unfortunately, he finds that the key issues in healthcare revolve around inefficiency, fragmentation, and a lack of a team-based approach that is centered around the patient’s best interest. This inspired him to work with Vivante Health, so patients with digestive issues could get the personalized, tech-forward support they need to heal. And with digestive disorders—everything from reflux to IBS to autoimmune disorders—making up a burden of $136 billion dollars on an annual basis, it’s clear that there’s a serious need. Vivante Health serves the large, underappreciated, and sometimes stigmatized realm of digestive disorders with a comprehensive and personalized digital platform. Patients are provided with a care team, including a licensed dietician and health coach, and their progress is supported with app reminders, appointment support, check-ins, and progress reports. Although tech is leveraged to best support the patient and their results, it’s the care team outreach and their personal touch that bridges the gap for truly positive user experience and improved outcomes. The care team at Vivante Health has an NPS rating of nearly 80. They work primarily with employers and are flexible in the way they integrate with new and existing systems. Although excited for everything currently underway, Simon looks forward to more clinical pathways and screenings in the future to continue to help patients quietly or outwardly suffering from digestive disorders. Here’s a glance at what we discuss in this episode: 01:00 - Introducing Simon, his accolades, and how he came to work with Vivante Health. 03:00 - He studies the space of digital health, it’s gaps, and it’s solutions, which was a perfect fit for Vivante Health. 04:20 - Key issues in healthcare: Inefficiency, fragmentation, and a lack of a team-based approach.06:45 - On digestive disorders: Nobody has digestive disease in general, they have something specific like reflux, IBS, a type of liver disease, pancreatitis, etc. 08:25 - Digestive disorders make up a burden of $136 billion annually; they come with a stigma and people don’t always feel comfortable with it. 09:38 - How digestive disorders are being treated today and the cost implications vary widely, as the types of disorders vary.12:30 - The link between gut health and overall health, including immune and emotional health; there’s a connection.15:05 - The Vivante Health product and service; the space they serve is large and underappreciated.15:40 - It’s a comprehensive digital platform that addresses the management of the digestive disease and is integrated with common tech and a care team.16:15 - With a health coach and licensed dietician, patients get a personalized program based on their history, gaps in care, best practices, and evidence. 19:05 - How they improve the customer experience: App reminders, appointment navigation, health coach support, check-ins, assessment tools, and progress reports. 21:30 - The microbiome assessment: Certain diets/lifestyles have certain bacterial compositions and we can manipulate that bacteria, our microbiome. 25:00 - The clinical rigor and evidence are of utmost importance for Simon and Vivante.27:30 - How progress is tracked with Vivante Health: Assessments, trend anticipation, self-management improvement, and care team outreach.30:45 - Their care team NPS rating is almost 80 and people appreciate a personal touch. 31:45 - On cost: Over 2x ROI according to a case study, great feedback, and great savings and experience. 33:15 - Marketing the program and getting patients; they have full-spectrum support depending on what a client wants and needs. 34:20 - Fee structure: It’s usually per active member per month, on a quarterly basis; people don’t get billed for something that isn’t used. 35:30 - They have a dozen clients and a great spectrum in terms of the number of employees; they have several thousand active members.36:30 - The challenge: Many people don’t realize how big a deal digestive disorders are. 42:35 - Exciting things ahead: Clinical pathways and screenings to help people better and more easily; data, research, and analytics that are underway. ResourcesVivante Healthsmathews@vivantehealth.com

In this episode, Michael introduces Dawn Cornelis, the co-founder and Chief Transparency Officer of ClaimInformatics. ClaimInformatics is a payment integrity solution that helps its clients identify improper healthcare claim payments and recoup the money for the employer. When Dawn entered the world of claim processing 30 years ago, it didn’t take long for her to see that money was being wasted on a massive scale via unnecessary procedures, upcoding, bad systems, and egregious contracts. Unfortunately, there’s more abuse now than ever. With 3-7% of healthcare claims being inaccurately paid, it’s grown to be a problem that is worth over a trillion dollars. This inspired her to co-found ClaimInformatics to catch errors, fraud and contain costs for members. She emphasizes that these costs aren’t savings, it’s money that shouldn't have been paid in the first place. ClaimInformatics has a process where they are able to identify six levels of errors that lead to overpayments, including upcoding, miscoding and outright fraud. They review ASO/TPA network agreements, acquire and review all data, re-adjudicate claims, then share the results with clients to illustrate the level of overpayment in their plan. From there, they initiate the recovery process where they typically recover 80% of improper payments on behalf of the employer. In addition to recouping money for the employer, they put providers on notice who are engaging in egregious billing practices that they are now being watched and will be reported to the Network and Medical Board if behavior continues. ClaimInformatics works primarily with clients who are self-funded and under ERISA guidelines. They have flexible fee structures with aligned incentives to generate results for their clients. Dawn recommends everyone take a hard look at their reports, review their ASO agreement, and become acquainted with their performance audit terms. ClaimInformatics stands for integrity and member-centric service, and we’re excited to see how they continue on this trajectory into the future. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Dawn, the co-founder and Chief Transparency Officer of ClaimInformatics.02:30 - 30 years ago, she got into the claim processing and became a System Configuration Specialist; she then became a plan administrator for a Fortune500 commercial group. 05:35 - They read the story in the data, and the data isn’t good in terms of waste via unnecessary procedures, expensive services, bad systems, and egregious contracts. 07:45 - ClaimInformatics is all about integrity; they ensure payments are accurate and in accordance with agreements made. 08:30 - They catch errors and fraud to contain cost; it’s not savings, it’s money that shouldn't have been paid in the first place. 10:55 - Why are we still seeing 2-3% leakage when that waste is 100% preventable?11:15 - Most of their clients are self-funded and under ERISA guidelines. 11:30 - The ClaimInformatics process: They review ASO, ascertain and review all data, re-adjudicate claims, then take the results to show clients what they’ve captured.12:50 - They follow the same guidelines as a claim’s office, make deposits on behalf of clients, and are member-centric in terms of protecting their overpayments, too. 14:05 - They ensure member liability is made whole; they go back three years and see lots of coding and billing errors that are non-compliant of the rule sets. 17:15 - Historical claims review results: Incorrect codes and upcoding make groups and members pay more. 19:30 - Medical records either support or don’t support the coding choice; they have seen upcoding happen frequently across the board with outside billing companies. 21:10 - There’s more abuse today than ever; there are six levels of errors that they’ve identified. 25:22 - Providers are paid based on the severity of illness of a patient; adding diagnoses and up-coding increases payment.27:05 - Deliverables: Clients have full access to the ClaimInformatics portal, they identify, track and seek causation to create a solution at the root level. 28:50 - The provider response: ClaimInformatics gives extreme detail to the provider so they can make a change to their behavior and the way they’re operating. 31:20 - They make it so that any overpayments can turn into a credit. 33:05 - They contact providers to let them know that their data is under scrutiny; groups don’t typically get their money back on large fraud cases. 35:10 - 3-7% of healthcare claims are inaccurately paid; they have an 80% recovery rate. 39:45 - Their fee structure: Risk-free at a contingency rate; they don’t want to add to the cost; they can do per member per month as well. 41:05 - Employer fiduciary responsibility: They created a safe harbor program to fill fiduciary responsibility. 43:45 - A primary takeaway: Employers can start asking for reports from administrators to see what they are doing to capture things on the front and back end. 45:00 - Review your ASO/TPA agreement and performance audit terms.46:35 - They’re excited about the legislation out there that is forcing the hand of big organizations; they’re here to support in the right way. 47:00 - It’s a $3.7 trillion dollar problem that includes having trouble accessing data that ends up speaking for itself. ResourcesClaim Informatics

In this episode, Michael introduces Jim Wachtel, the Executive Vice President of Sales and Marketing for Renalogic. Renalogic is dedicated to helping employers manage kidney disease in their employee population and reducing dialysis costs with preventive programs and pricing solutions. Jim was inspired to enter the healthcare industry because he recognized the cultural issues around healthcare. He wanted to support a company that not only helps make treatment accessible to those who need it but also takes measures to prevent chronic illness in the first place. With this mission in mind, Jim found Renalogic. Renalogic works to reduce the costs associated with dialysis — a treatment for End-Stage Renal Disease (ESRD) — and offers a Kidney Dialysis Avoidance Program for at-risk members. Kidney disease is known as “the silent killer” for a reason: It is estimated that 40% of people with kidney disease don’t know it. And if it progresses from Stage 5 to ESRD and dialysis begins, treatment is expensive — up to $1.3 million per year, per member. Renalogic started with cost-containment solutions, but their goal is to actually put their cost containment business out of business and focus on prevention instead. They have had a 99.3% success rate of keeping people off dialysis and have, in many cases, helped members reverse their kidney disease. They do this with personalized coaching that empowers participating at-risk members to take charge of their health. This, in turn, creates a ripple effect in their families that inspires cultural change one household at a time. As far as payment goes, Renalogic imposes payment on the dialysis provider and works to ensure Medicare is maximized for those who qualify, even before the age of 65. They have a proprietary way to re-price claims in a way that is fair and defensible. For their Kidney Disease preventive program, they have a pay-for-performance structure and only bill for employees that have signed up to work with their nurse practitioners/coaches. Renalogic has an exciting future ahead that includes a data service that will allow better service for those at-risk for kidney disease. And with a big vision that includes a healthier culture through education, empowerment, and preventative support, we are excited to see how the trickle-down effects of Renalogic’s efforts play a role in the health of future generations. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Jim, Renalogic, and Jim’s background and education.02:00 - He knew we had cultural issues around healthcare and that “the American lifestyle is wreaking havoc on chronic disease”.03:30 - Jim became interested in working with companies that help combat chronic illness and disease. 04:45 - The problem is that the expertise required for solutions is hard to find; for employers, it’s hard to keep costs down while still providing quality care. 06:00 - A small percent of the population is a majority of the costs; this 5% needs to be addressed in a reactive and proactive way.07:05 - They empower members to take charge of their health and don’t see people as a line item cost.09:20 - A large percent of the population has some stage of chronic kidney disease and up to 40% of people who have it don’t know it. 10:35 - After Stage 5 of chronic kidney disease, you go into ESRD which is when dialysis is started; it costs up to $1.3M/ year per member, the 3rd highest flagged stop-loss claim.11:45 - The dialysis marketplace is concentrated and the duopoly in the market doesn’t have an incentive to lower costs. 13:15 - They started with cost-containment solutions and have a system to re-price claims in a way that is reasonable and fair.16:06 - ESRD makes you eligible for Medicare before age 65 so that becomes a second payer and becomes primary after the waiting period.17:30 - They “impose the payment on the provider”; why using reference-based pricing with multiples of Medicare can be risky for an employer.19:12 - When Medicare re-prices a claim, there are about 13 different variables they use and it’s hard to determine what they’d be; it’s arbitrary and capricious. 20:15 - They have good relationships in the stop-loss marketplace, brokers, and consultant community.22:30 - People are getting sicker and sometimes go into emergency dialysis; it would be better for it to be a gradual process. 23:50 - They want to put their cost-containment business out of business by preventing dialysis from ever happening in the first place with clinical solutions. 25:18 - They’ve had a 99.3% success rate of keeping people off dialysis and have reversed kidney disease in many cases; they specialize in finding at-risk members.28:40 - Of the population they identify, 30 - 40% participate; blood tests show if people are reversing the disease. 32:50 - They collect member stories and testimonials and offer a coaching-type relationship with members to fill the gap in the industry for that type of care. 35:00 - People need that human touch; they use tech to support the process, not to replace the actual connection or engagement. 36:05 - They have set-up fees and their Kidney Dialysis Avoidance Program is essentially a risk management tool until cost management is needed39:25 - They’re working on data service and are using machine learning and A.I. to serve their industry better.40:30 - Making cultural shifts in terms of health have a trickle-down effect; the next generations can learn how to be healthier.ResourcesRenalogicJim’s LinkedIn

In this episode, Michael introduces Dr. Cristin Dickerson, a founding partner at Green Imaging, a full-service virtual medical imaging network owned and operated by board-certified radiologists.Dr. Dickerson founded Green Imaging to provide affordable, high-quality medical imaging for uninsured and high-deductible patients across the U.S. While she was working for a radiology group in Houston, she realized that she didn’t have control over many aspects of quality or her hours, and everything in Houston was extremely overpriced for patients. Instead of opening a brick-and-mortar center, she instead found imaging centers that were at 50% capacity and bought their unused time at a discount. These were savings that she could then pass on to the patient. Green Imaging also reverses the traditional billing model so they’re in control of the finances and eliminate the issues that come from split billing. Although pricing can fluctuate in different geographic markets, they’ve still been able to achieve up to 60% savings relative to insurance carrier network discounts. Green Imaging is seen as a great referral source for many imaging centers, driving utilization by helping employers communicate the benefit of their service. They are appreciated by patients, employers, and centers alike, and have a 4.9 average star rating to prove it. Green Imaging has partnered with 1,400 imaging centers and counting, and they are currently serving 250,000 lives across the country. With more employers looking for affordable and creative solutions for their employees, we’re excited to see Green Imaging grow through aligned incentivization, affordable costs, and quality service. Here’s a glance at what we discuss in this episode: 01:00 - Introducing Dr. Cristin Dickerson, her background, education, and inspiration for founding Green Imaging. 02:20 - Cristin’s journey from being a physician to being a healthcare entrepreneur, her mission, and how the Radiology Group of Houston evolved. 04:00 - The issues in the imaging industry that Cristin saw and wanted to be solved; quality control, price, and an ability to control her hours. 05:15 - The difference between Green Imaging and traditional imaging and radiologist processes. 07:30 - The biggest issue in our healthcare system: 70% of doctors are employed by or subsidized by hospitals; hospitals are more expensive than independent physicians. 08:50 - COVID-19 is challenging employers to look for more creative and affordable solutions for employee healthcare. 09:15 - Why diagnostic imaging is so expensive: Physicians owned by hospitals are incentivized to keep care in the hospital system.11:20 - Radiology groups and the issue with split billing; the “surprise bill”, the scan, and the interpretation. 13:30 - Price variations in the market: The game between hospitals and insurance companies often leaves the patient paying way more for imaging than they should. 17:00 - Michael shares a story of when he was quoted $2,500 for an MRI that he found elsewhere for $500.17:30 - The Green Imaging product and service: She lets the imaging center set their pricing and they’re all very interested in contracting right now. 18:45 - Pricing is variable because the market is variable, but they have been able to achieve 60% savings.21:30 - Green Imaging is the best referral source for some of the imaging centers because they wouldn’t otherwise be at capacity or be able to find new patients easily. 22:40 - They can pay within 2 weeks of receiving a claim; sometimes it takes longer to receive the claim.23:45 - They have partnered with 1,400 imaging centers and will be in all states except New York and will shop for care if there isn’t a center near a patient.24:50 - How billing works: Everything goes through them and is made easy through their app and their claims and reference-based pricing. 26:35 - They work best as a bolt-on plan like vision or dental; they also have plans with TPAs, employers, and cost-containment companies.28:00 - How they drive utilization: Branded content for employers, $0 out-of-pocket materials that educate and explain the coverage to patients. 30:30 - There’s been a 60% drop off in cancer diagnosis because of COVID-19, which means people aren’t getting checked and may suffer through later stages. 31:35 - They get 6% more reviews in general than the average healthcare provider and hover around 4.9 stars.32:00 - They cover around 250,000 lives right now and are growing due to the COVID-19 situation as employers seek more affordable options.33:30 - The cost is built into the claims; there’s no up-front cost and Green Imaging is incentivized to keep costs low to keep clients. 34:15 - Cristin is excited to roll out an enterprise software to direct patients to the lowest priced care and help them see it as a benefit and aligned incentive. 35:40 - Near and onsite clinics can help provide better care in the future; Zoom is allowing patients and doctors to be closer and communicate more. ResourcesGreen Imaging

In this episode, Michael introduces A.J. Loiacono, the CEO at Capital Rx, a pharmacy benefit manager seeking to create the first efficient and transparent marketplace for prescription prices and ultimately reduce prescription costs for employer groups. A.J. has over 20 years of experience in pharmacy benefits, finance, and software development. Although he never thought he’d end up in the same industry as his father, he loved the nature of pharmaceuticals and recognized the inefficiencies within the system. He realized that, although every other industry has changed massively over time, pharmacy benefits have gone largely unchanged for over 20 years. The problem with the pharmaceutical industry is that buyers (employers) and sellers (pharmacy stores) haven’t been able to communicate freely about pricing. Instead, they communicate through a PBM that inflates and distorts the true cost of the drugs. Capital Rx’s mission is to redefine the way prescriptions are priced and administered in the U.S. so there is more transparency and directness between buyer and seller. They do this through their proprietary Clearinghouse Model℠ that uses NADAC or National Average Drug Acquisition Cost to eliminate prescription drug price variance that is standard when using the AWP (Average Wholesale Price) + discount model. Capital Rx prides itself on its focus on administration and care, not price manipulation and setting. They have a high-touch process that both employers and patients appreciate and an NPS score of 92 to prove it. The Capital Rx platform is designed to create maximum value for the employer and employee and includes low net cost formularies, simplified/transparent contracts, and rebate guarantees, and high touch service and reporting for both the employer and consultant. With success stories abound and a transparency-based model, we’re excited to see how Capital Rx continues to redefine the pharmacy benefits space long into the future.Here’s a glance at what we discuss in this episode: 01:00 - Introducing AJ Loiacono, his background, mission, and work in the industry. 04:10 - He read about software conversions for pharma in Forbes and was intrigued. 06:30 - He’s studied the pharmacy supply chain and understands the drug pricing.07:30 - The shift from volume to value; We give incorrect value to pharmaceuticals. 08:55 - Drugs are inflated and pharmaceuticals have an inelastic demand curve. 10:30 - The haziness around drug pricing controls the supply chain.11:10 - PBMs and carriers adopted one formulary for the best rebate. 12:40 - Buyers (employers) and sellers (retail pharmacies) should freely communicate on price, but the PBMs prevent it, which is problematic.15:10 - AWP Data says in the second line that it shouldn’t be used as a price point. 16:30 - They use NADAC pricing; they find it more transparent and contrasting with AWP.18:40 - Price only changes if CMS sees a +/- 2% shift; many states use NADAC.19:06 - Capital Rx is the only PBM that built a network around NADAC.21:00 - NADAC is a closer approximation to what the pharmacy actually pays. 22:05 - Pharmacies are hesitant to reduce the price because the savings never make it to the payer; the artificial variability doesn’t come from the pharmacies. 23:30 - There’s no crazy price fluctuation in the Capital Rx model because they use the same benchmark across the board. 26:50 - Inflation in the NADAC model in relation to the AWP; NADAC deflates 10%/year for generics, it was deflating in AWP as well, but the consumer sees an increase. 29:50 - It all goes back to a lack of communication between the buyer and seller because of that middleman that pads profits. 32:45 - They have value-driven formularies and are focused on value, precision, and removing waste. 38:10 - They quote their rebate guarantees on a per-member per-month basis; why this method is better for the employer41:20 - Consultants need to be willing to ask the right questions.42:05 - There is an inherent conflict of interest when PBMs get profit based on a percentage of drug prices and can make additional money on the spread. 45:50 - With high-touch PA they make three calls; one to the patient, one to the physician that prescribed the drug, and to the pharmacy to ensure inventory. 47:15 - People appreciate their high-touch, proactive process, and outreach; they’re paid on administration and care, not price manipulation and setting. 53:14 - Results and savings: On average, their clients see an actual PEPM savings of 13%57:30 - We get so caught up on reducing the cost that we forget that healthcare is an investment. 01:01:45 - Success stories: They helped a company get rid of its 30-day waiting period. With the savings, they expanded paid-leave for some exempt employees. 01:03:00 - They always ask, “What are we solving for?”01:30:30 - The future of pharmacy benefits; care and treatment will become more personalized. ResourcesCapital Rx

In this episode, Michael introduces Jason Hellickson, the CEO of Regenexx, a global provider specializing in interventional orthopedics. Regenexx partners with self-funded employers to significantly reduce their orthopedic spending while providing employees a choice in care. Regenexx orthopedic procedures leverage the body's natural healing ability to repair damage to bones, muscles, cartilage, tendons, and ligaments non-surgically and with great outcomes.Jason is a long-time athlete who underwent shoulder surgery in 2008. Although the surgery was deemed “successful”, the fact that it took him 12 months to recover, 12 months to swim again, and lasting pain caused him to question whether there were better alternatives. Years later, when he received the same prognosis on his other shoulder, he insisted on an alternative. With Regenexx he was able to swim again just 6-8 weeks after the procedure. He learned that Regenexx could be offered through a self-funded health plan, so he partnered with them as an affiliate and then later became the CEO.Jason believes that our orthopedic care continuum needs a reinvention because surgery is no longer the only option. With almost 6% of GDP spent on elective orthopedic surgeries a year and about 50% deemed ineffective, the reinvention includes new and advanced “interventional orthopedics” that cut costs, are less invasive, and frequently allow patients to avoid surgery altogether. Regenexx is backed by clinical research, saves employers up to 70% on elective surgeries, and saves patients the pain, recovery time, and uncertainty of surgery. And with a research-based and outcomes-monitored model, they are transparent, ensure a high standard of care and have a comprehensive accreditation process to be part of their provider network. They work with employers as a direct contractor and help educate members on the benefits of interventional orthopedics so members are informed and know it’s an option to consider in lieu of invasive surgery. With a Net Promoter Score of 74, their education and service are clearly working. In addition to high member satisfaction, Regenexx has also recently been awarded the Traction Award at the Employer Health Innovation Roundtable. Just from the event, 12 large employers agreed to move forward with Regenexx - a big win that seems to be just the beginning of an exciting road ahead.Here’s a glance at what we discuss in this episode: 01:00 - Introducing Jason, Regenexx, his background, and his unique journey. 03:00 - He got one surgery and began looking into alternatives for his other injuries.04:00 - He found Regenexx, entered into an affiliate partnership, and became the CEO.06:30 - Issues from a care and cost standpoint in orthopedics: almost 6% of GDP is spent on elective orthopedic surgeries a year, yet 50% are deemed ineffective procedures.08:20 - Many people put off surgery for an average of 5 years; this “gap in care” leaves them in pain which is where “interventional orthopedics” comes in. 09:30 - Interventional orthopedics is a less invasive and needle-based procedure using orthobiologics (your natural healing cells). 12:30 - The healing happens at a cellular level and allows the body to unleash its natural healing powers.13:30 - Efficacy rates: Orthopedics used to be the only option, so efficacy was not considered; Regenexx clinical research and studies prove its efficacy. 16:15 - Regenexx is research-based and outcomes-monitored; proper diagnosis, a well-executed procedure by a skilled physician, and orthobiologics.18:00 - They vet and constantly educate their physicians and lab techs to ensure a standard of care that is monitored within a transparent outcomes database.19:20 - They have 75 locations and over 100 physicians across the country, and growing.19:50 - The average cost of orthopedic surgery is around $25,000-30,000; the average cost of Regenexx is $4,500, saving employers up to 70% on elective surgeries. 21:10 - Regenexx directly contracts with the employer and has a centralized billing system and transparent fee schedule.23:00 - Engagement and awareness: Employers add Regenexx to their care package and help educate and steer members towards Regenexx so they know it’s an option. 24:30 - They offer a newsletter, a benefits card, targeted outreach, and now some employers are implementing a clinical care pathway that requires Regenexx to be evaluated prior to surgery. 26:00 - If someone is a possible candidate for knee replacement, they have to have a Regenexx evaluation first; an example is 49 out of 50 electing Regenexx through a clinical care pathway 27:30 - The necessary orthopedic continuum: Educate, incentivize, and proper clinical care pathway. 28:00 - The Net Promoter Score and testimonials: Many people spoke about the elevation in their quality of life. 29:30 - The Employer Health Innovation Roundtable (EHIR): Regenexx was awarded the Traction Award and 12 employers agreed to move forward with Regenexx. 32:30 - Anyone that has their own SPD can add Regenexx to their plan; they also have a telehealth and transportation model to consider. 33:30 - He’s excited to partner with innovative broker partners in the future. ResourcesRegenexxRegenexx CorporateJHellickson@Regenexx.com Regenexx YouTube

TopicsRevenue Cycle ManagementRising healthcare costsBundled PricingCost SavingsCenters of ExcellenceImproving Employee ExperienceIn this episode, Michael introduces you to Sachin ‘Sach’ Jain, CEO of Carrum Health. Join us as we discuss how Carrum Health has created an alternative marketplace for lower-cost surgical procedures with a focus on creating an exceptional employee experience.Here’s a glance at what you’ll learn in this episode:Who Sachin Jain is, and how he found his way into the healthcare field.The Healthcare Marketplace – Why supply and demand play such a vital role in costs, and why the healthcare marketplace doesn’t interact or operate like any other marketplace for service and goods in the country.How Carrum Health is working to solve two systemic issues in Healthcare payments todayHow Carrum Health created a marketplace for select surgical procedures that sits outside of traditional HMO/PPO network to allow providers to compete directly for the employer’s business.Why the bundled platform that Carrum offers runs 40-50% cheaper than pricing through traditional insurance carrier networks.The screening process – What Carrum does to ensure their Centers of Excellence providers meet the highest level of quality.What geographical regions Carrum is available for employersHow Carrum is geared towards the patient experience, and how they strive to remove the stress of surgery and hospital stays so that patients can focus on healing.Costs to participate in the Carrum platformwww.carrumhealth.com   

In this episode, Michael introduces Marek Ciolko, the CEO of Gravie, a unique health plan that offers employers a shared savings model and employees the opportunity to personalize their insurance to meet their needs. Gravie does this by helping employers control costs while still providing employee-selected coverage and a better experience throughout the process.Marek has a long history of operations management for Deloitte and companies within the healthcare industry. It was on this journey that he realized that there are only so many ways to bend the curve and reduce healthcare costs for everyone with incentives alone. He realized that the core of health insurance needed to be tackled, which is why now, through Gravie, he strives to level the playing field between the group and individual marketplace of health insurance within their platform. The current state of the world with the COVID-19 outbreak makes it painfully obvious that the consumer is underserved in our current system. Gravie’s mission is to improve the way people purchase and access healthcare. They focus on an underserved area of the market, which is group sizes with between 100 and 1,000 lives. Gravie works with employers to establish a defined contribution and then provides a platform of plan design options for employees to select from that meets their individual needs. In essence, Gravie is a marketplace and a decision support system for employees.In addition to offering a marketplace to employers, the Gravie product is a level-funded offering that helps small employers self-fund, manage risk and share in excess surplus when claims are less than expected; to date, 30% of customers are receiving refunds at the end of the year. As a startup with 3 years of experience, Gravie is already taking massive strides to control healthcare costs for middle-market employers and employees and we look forward to seeing them grow and expand their offering. Here’s a glance at what we discuss in this episode: 01:00 - Introducing Marek, his background, and his motivation for launching Gravie. 02:30 - He worked for Deloitte and RedBrick Health and learned the challenges with healthcare costs. 04:00 - With Bloom Health, they worked to make insurance customizable so employees could shop and the market could provide what they need. 05:05 - Gravie levels the playing field between group and individual insurance marketplace by granting true consumer involvement in the selection process. 06:55 - Health insurance is very expensive - our current global climate is highlighting that issue. 09:00 - Sometimes companies don’t have enough choices for their employee’s diverse needs; people end up getting more than they need or not having enough.09:50 - Consultants and brokers oftentimes see the employer as their client, not the employee. 10:30 - Customization and tailoring allow the consumer to pay for what they need and leave out what they don’t.12:00 - Employees have to go through their employers for health insurance, which makes it expensive for employers to attract and retain employees year over year.  15:20 - Employers need a way to cap (fix) their healthcare liability while keeping their employees happy - that’s where Gravie comes in. 17:11 - Gravie offers cost predictability and management of the entire system, including insurance, the administrative process, savings benefits, and employee customer service. 20:00 - It leverages stop-loss and helps small employers self-fund easily; Gravie gets a share of savings when claims are less than expected, so they’re incentivized to keep costs below the employer’s cap.24:00 - They’ve been in business for 2-3 years and have seen 95% retention and 30% of customers receiving refunds at the end of the year. 25:30 - The resources and programs they offer are medical management, innovative cost-containment measures to minimize peaks, and virtual care. 27:50 - What employees can expect at enrollment: Many plans to select from and a simplified process. 31:30 - They’ve designed an intuitive UX model; people are wary of healthcare and what coverages they really get. 33:20 - As an easy button option, employees have the option to default to a standard plan.34:33 - Their most recent customer satisfaction score was 95%. They also read data to see how well the platform is working.35:40 - Retention is also a critical data point, as is understanding buying behavior. 36:05 - They currently have 9,000 lives on their platform - they’re working with new brokers and partners who understand the need for new solutions. 37:25 - Their target market: 100 - 1,000 employees, which is the segment of the market that is the most underserved in our country. 38:45 - Geographic limitations may apply for smaller groups; this is a good fit for employers who want to define contribution philosophy. 40:45 - COVID-19; They’ve seen a lowering of activity physically, a spike in virtual care, and new, mid-year insurance enrollment options. 42:20 - They’re reaching out to employers that are in pain to help them through this tough time. 43:40 - Will the COVID-19 change be lasting? Will employers take a new, radically different approach to healthcare that is permanent?44:40 - Michael shares his predictions for the future of healthcare. 45:30 - Marek thinks employers will look for solutions that take out uncertainty.  46:30 - The origin of the name “Gravie”.ResourcesGravie

In this episode, Michael introduces Steve Watson, a CFO/CHRO and founder of Trendbreakers, a community of finance, human resources, and benefit advisor professionals that are on a mission to break the trend of rising employee healthcare costs. Trendbreakers helps CFOs, CHRO’s and business owners make the best employee benefit decisions by offering support, education, and consulting. Steve is a unique guest because he’s on the payor side of business...i.e., he is working for an employer who ultimately pays for healthcare via their insurance. He recognizes that the current healthcare system is lucrative for organizations and certain people, but also sees the problem with employers and families paying heavily for benefits they may not even use. A few years ago, his employer had a million-dollar claim that was going to increase premiums by 30% - and his broker’s commission by 30%, too. Through deeper investigation and learning, he recognized the incentive imbalance and that the system was rigged against employers.  He was able to slash his company’s benefits costs, save thousands, and allow employees to enjoy no increases and better benefits - all while drastically reducing the administrative burden of enrollments and changing plans. After doing it for his own company, Steve realized that others in his position needed the network, strategies, and best practices to do the same. So he built Trendbreakers, the educational platform that helps inform business owners, CFOs and CHROs make the best healthcare decisions for their company and its people. Steve believes that a lack of accountability across the board has been a detriment to the system as a whole. He believes brokers must be transparent, accountable and have a high level of expertise in the exact areas their clients need so they can offer the best solutions. He also recommends brokers be conscious of the way they communicate with employers and use words and comparisons they can understand. Brokers have an excellent opportunity to educate and be a fiduciary for the employers they serve. And it’s important that employers have a plan in place that they’re confident in and has room for continued growth and savings down the road. Trendbreakers has a promising road ahead bridging the gap between peers and colleagues to create a system where everyone benefits.Here’s a glance at what we discuss in this episode: 01:00 - Introducing Steve, the CFO, CHRO, and founder of Trendbreakers. 05:30 - What Steve thinks about our healthcare system and when the reality sunk in. 09:30 - He transitioned into a self-funded plan to address the issues. 12:00 - Now, he can impact the results, get data, and benefit from no claims.13:05 - Employees have benefited from no increases, better benefits, and they lifted the administrative burden of having to have an enrollment.13:30 - Trendbreakers provides education to company leaders, executives, and HR leaders so they understand the industry and speak the same language. 14:50 - Broker/Consultant must-haves: Transparency, accountability, expertise.17:05 - Brokers don’t always share new solutions with their clients that could save them significant dollars. 20:00 - Brokers must communicate concepts in a way that the CFO/CHRO/owner understands because in many cases, they’ll need someone else to sign off on it, too.22:20 - CFOs want to know the internal risk and meet other people who are self-funding to feel confident about their decision. 24:10 - It takes peers, stories, and a group for people to feel confident about making a decision - just listening to a broker isn’t enough.25:05 - If an HR leader needs to get the rest of the leadership on board, they must first do things on the back-end that won’t change anything for the employees. 26:30 - Have a 3-5 year plan and make incremental changes - each step will make you money. 27:00 - Steve is excited for the next level of savings for his company, for Trendbreakers he’s excited to see the conversations lead themselves. 28:00 - He’s also excited to speak onstage about Trendbreakers and continue bridging the gap between HR and CFOs.ResourcesTrendbreakersLinkedIn

In this episode, Michael introduces two partners of ScoutRx, Robert LeCureaux, the VP of Client Development and Amy Bandy, the VP of Operations. ScoutRx helps employer groups and members maintain affordable prescription drug costs through the use of their three core cost containment strategies. When previously working in the pharmacy and PBM industry in very different roles, Rob and Amy both recognized that it was very profit-driven and not much thought was given to the consumer and the burden of cost. They didn’t like this status quo - and how members had no voice and too many roadblocks - which is what inspired them to team up with other partners to create Scout Rx.  With a lack of marketplace options to address the rising price and utilization of specialty medications, ScoutRx has made it their mission to bring overall costs down and create a better member experience. To date, they have been able to drive an average savings of about 43% for their clients, a sign that they are succeeding in their mission thus far. To be clear, ScoutRx is not a pharmacy benefit manager or administrator. They’ve partnered with a PBM to administer their program while they use their own core strategies autonomously. ScoutRx operates using three core strategies: Their Specialty Pharmacy Program, Copay Optimization Program, and International Pharmacy Program. Through their Specialty Pharmacy Program, they help members pay little to no money out-of-pocket for specialty drugs by finding drug manufacturer foundations and financial programs that patients can qualify for to offset the entire cost of the drug. The Copay Optimization Program takes advantage of drug manufacturer coupon cards to reduce the cost of the drug and potentially eliminate the patient’s copay altogether. The International Pharmacy Program allows members in the U.S. to get their high-cost or specialty medications from Canada at a substantially lower cost with eliminated copays and reduced cost to the group. The amazing part about all of this is that most of the logistics are done behind-the-scenes at ScoutRx with little effort needed from the patient. And as far as savings go? Some groups that they’ve worked with had a 96% generic utilization rate and were still able to save over $100,000 in their first year. The savings range in the first year is vast - from 16% all the way up to over 70% - and these savings continue into future years which will lead to lower inflation than employers would see with typical PBM’s and insurance carriers in the industry. ScoutRx is paid a percentage of savings which they outline in regularly distributed, fully-transparent, line-by-line reports.ScoutRx is a good fit for small-to-midsized self-funded companies with 2,000 employees or less. While ScoutRx is a new company, its leadership team is experienced and its methodologies are proven. ScoutRx has a bright future ahead disrupting our healthcare system by making high-cost prescriptions more easily accessible to patients. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Rob and Amy, two partners for ScoutRx.03:00 - The inspiration for ScoutRx: Rob saw that the industry was profit-driven and that not much thought was given to the consumer. 04:30 - Amy saw all the roadblocks between members and their prescriptions in the traditional setting and wanted members to have a better option. 06:00 - The key issue with the drug delivery and payment system of today is that specialty medications are often inaccessible to groups and patients. 10:30 - Their specialty pharmacy program addresses accessibility so that patients can get pharmaceuticals for little or no cost. 11:50 - The Patient Assistance Program - It’s a financially-based program where the manufacturer offers its medication free of charge for those who qualify. 13:30 - ScoutRx helps its members through the complex eligibility and qualification process that is tough and expensive to do alone. 15:10 - Traditional PBM’s have no interest in this - it’s labor-intensive, hands-on, and concierge-level, plus they get revenue from specialty meds at their in-house pharmacies. 18:20 - Copay Optimization leverages copay cards received directly from the manufacturer.22:30 - The International Pharmacy program utilizes a partner pharmacy in Vancouver to get high-cost and specialty medication at a lower cost - and mailed directly to members.26:30 - Rob’s father goes to Canada monthly to get his insulin medication because it’s so much cheaper in Canada and he’s on Medicare. 27:50 - They utilize a retail pharmacy, not a broker because there’s no regulation on brokers and they want members to get what they could get at a local pharmacy in the U.S. 29:15 - Their international program is voluntary, not mandated, and labeled under “personal importation” - which makes it within all legal limits. 31:05 - ScoutRx members see a savings range of 16-70+% in their first year. 33:50 - They get paid off a percentage of savings and are transparent about what they’ve earned with regular reports. 35:45 - ScoutRx could be a good fit for small-to-midsized self-funded companies with 2,000 employees or less.38:20 - The worst-case scenario of moving to ScoutRx would be that you’re in the same position you’re in now; it isn't too good to be true.40:55 - They’re working with about a dozen employers now; their concept may be new, but their methodology isn’t.ResourcesScoutRx

In this episode, Michael introduces Matt McCambridge, the co-founder, and CEO of Eden Health, a virtual primary care and navigation platform centered around care teams. Eden Health helps employees navigate today’s complicated healthcare landscape across insurance, primary care, and mental healthcare so they can make smart, well-informed and cost-conscious decisions. Matt had a personal situation that influenced his decision to move out of the venture capital space to launching a start-up in healthcare. When Matt’s sister was sick as a kid, Matt and his family personally witnessed the broken components of the healthcare system. Now, Matt is seeing how the “coordinated care” offered by Eden Health has made a difference in the lives of patients like his sister.   Eden Health is a certified Primary Care Medical Home - the top-of-the-line quality certification in the country for primary care; this model emphasizes team-based care, communication, and coordination, which has been shown to lead to better care and why Eden has integrated specialties like behavioral health and physical therapy. The reason for including behavioral health, Matt explains, is that many other health issues are rooted in mental health conditions and these must be addressed to make meaningful progress with the patient’s health conditions. Matt’s company is different than other in-person or virtual primary care solutions in that it is highly integrated with a core focus on eliminating the employee’s hassle as a patient. Typically, it’s very confusing for employees to figure out where to go and for what, which is why Matt believes you simply cannot separate navigation from primary care and delivery. For this reason, they have an app with the accessibility to virtually chat with a doctor 7/365, and this connection enhances the solutions offered. By leveraging technology, they’ve been able to provide their users with the appropriate instant and personalized care. Eden Health also offers physical locations across the country for those who need it, and will even send a provider from their pool on-site to the workplace. Matt understands that the key to helping patients is engagement - and that engagement is more likely to occur if patients are receiving high-quality care through an integrated platform that they can easily use. Eden Health tracks their patients’ satisfaction with star ratings, and they proudly report an average of 4.95 out of 5 stars with a 75% response rate. Employers can engage with Eden Health in two ways: They can either fully-cover Eden Health for unlimited access or fully-insured with a fee that is reduced when insurance is taken into account since they would be considered an in-network provider. Eden Health has an exciting road ahead as they expand into new geographies and continue to grow and serve. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Matt, the co-founder and CEO of Eden Health. 03:00 - The insights Matt received about healthcare from doing venture capital.04:50 - The problems with the current primary care model. 10:00 - How Eden health is different from other primary care solutions. 13:20 - The importance of engagement that’s backed up by quality. 14:30 - Why behavioral health is integrated into the program.17:00 - On their certification as a primary care medical home.18:50 - Why it’s important that Eden Health makes 66% fewer referrals to specialists.21:20 - The process behind their specialist “closed-loop referrals” and how they short-cut the patient journey. 24:45 - Pop-up on-site visits, permanent brick and mortar clinics, and the experience they create in the workplace. 27:30 - On the trusted patient-provider relationship, how it keeps patients healthy over time, and a case study. 32:00 - On the integration of navigation at the primary care level and the feedback they’ve received. 37:00 - How Eden Health partners with employers and keeps their focus on the mid-market. 43:00 - Some exciting things up ahead for Eden Health and who Eden Health isn’t for. ResourcesWebsite: Eden HealthEmail: sales@edenhealth.com

In this episode, Michael introduces Gabriel Mecklenburg, the co-founder and COO of Hinge Health, a musculoskeletal solution for employers and health plans. Hinge Health is pioneering the world's most patient-centered digital hospital, starting with musculoskeletal health. Gabriel brings a unique perspective to the company because of his background in clinical research and because he, too, has been a patient needing this type of care. When Gabriel sustained a ligament tear practicing Judo while in college, he became exposed to many musculoskeletal treatments. He realized that the whole field was very much “behind the times” - and decided to switch his area of study to pursue a better solution in the industry. Because he felt distant from the patient when doing clinical research, he and his partner decided to do something that could positively impact patients at scale. When they realized there was nothing out there for musculoskeletal health from a digital health perspective, they created Hinge Health. Musculoskeletal injuries may be minor (a twisted ankle), acute (an ACL tear) or chronic (persistent lower back pain). Gabriel explains that chronic injuries are the biggest driver of avoidable cost. At Hinge Health, they focus on chronic injuries because they are the ones that, with the right care, can be lessened and eliminated without medications or surgery - which is what our current healthcare system resorts to all too often. The solution to chronic pain is multi-faceted. It requires physical therapy, ongoing education, and strategic behavioral change - and our current healthcare system simply can’t deliver on these needs despite the supporting research. Not only that, but the frequency at which a patient would need in-person care to get real results is totally unrealistic. The Hinge Health model takes established best-practices and turns them into their three-pillar approach that addresses exercise therapy, behavioral health, and education. Their educational component dispels myths and educates clients on scientifically-proven best practices, the behavioral health pillar helps patients create behavioral change that lasts, and the exercise therapy consists of sensor-guided movements with live feedback. They can do the exercises whenever and wherever - not just at a therapist’s office - and their adherence is tracked digitally. In a recent 10,000-patient study, 3 in 4 of their patients completed the entire 3-month core program. This level of treatment adherence is unheard of with traditional physical therapy, and a testament to the effectiveness of their program and the accountability provided through digital monitoring. More importantly, they’ve helped people reduce pain by over 60% - which is twice the reduction of pain you see when you put someone on opioids. Hinge Health will soon be releasing their digital musculoskeletal treatment study, which is perhaps the largest ever conducted in the industry. They’ve got a bright future ahead eliminating chronic pain and improving lives through their mission. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Gabriel, his background, and his inspiration for founding Hinge Health.05:45 - What falls within musculoskeletal disorders and injuries and which Hinge Health focuses on.07:45 - The problems with how the system is currently dealing with chronic musculoskeletal pain.09:50 - The Hinge Health model, their three-pronged approach, and how they engage patients with each approach. 15:25 - The patient journey: What to expect and how they’ve dramatically improved their adherence rate.21:45 - The quality of Hinge Health coaches and exercise therapists.24:00 - Meaningful results, why Hinge Health patients are engaged and see results, and how Hinge Health helps patients avoid surgery and drugs. 26:45 - The “sister conditions” that are often present with musculoskeletal conditions: Obesity, mental health (depression and anxiety), lessened productivity, and lesser quality of life.28:15 - A patient case study, their fee structure, their “aligned incentive”, and their current customers. 34:25 - The types of employers they work with and how they’ll be expanding in the future. ResourcesHinge Health Website

In this episode, Michael introduces John Powers, the Executive Vice President of Sales and Marketing for Advanced Medical Pricing Solutions (AMPS). AMPS provides market-leading healthcare cost containment services for self-funded employers, public entities, municipalities, labor unions, brokers, consultants, TPAs, payers, reinsurers, and HMOs. John is widely known as one of the most successful fraud investigators in the industry having conducted investigations in all 50 states and over 120 countries internationally. John dove into the healthcare industry about 12 years ago when he saw problems arising within the system. He found that many people held a misconception about their healthcare plans by thinking their plan covers everything when, in fact, it likely doesn’t. John believes consumerism is the missing link in our healthcare model, and he predicts a future where more employers move to a model of defined benefits. This, he believes, will make the system more equitable and transparent. Among other services, AMPS conducts medical bill reviews. They focus on hospital and facility claims, both inpatient and outpatient, that are in or out of the network. This line-by-line itemized review by coding specialists ensures that the correct treatment was done at the right time and for the right price - and their turnaround is only an average of 3.3 days. The problem is that most claim payers (TPA’s, Insurance Carriers) don’t get itemized facility bills, so they never get the chance to review them for errors and see where they’re being incorrectly charged. To complicate matters further, some health plans aren’t even requiring itemized Hospital bills prior to paying them. John speculates that this is because healthcare companies see hospitals as their most valuable asset. Shockingly, errors on hospital bills are extremely common, and 95% of the time they go unnoticed. AMPS uncovers errors in virtually 100% of bills ranging from $2 to $200,000, and most of their clients see an average of 10% in savings. And since AMPS only gets paid from the savings they find, there’s no upfront cost to using their service. The errors are corrected before the client pays the bill, as it’s notoriously difficult to request a refund after payment has already been rendered. John insists that if employers want to get control of their medical spend, they must unbundle the health plan components and get away from the limitations imposed by traditional insurance carriers. That way, they can review and audit their claims just as they would any other facet of their company’s budget. To prove why medical bill review is so important, John suggests asking your carrier account manager these three fundamental questions: Are you conducting a prepayment facility medical bill review for us, and if so, at what threshold and what are the results? How many errors have you found?  Are you a fiduciary to my plan? Please confirm what network discount I am getting and what does that equate to as a percentage of Medicare?John is confident their response will surprise and disappoint you, as they likely aren’t conducting a prepayment medical bill review, aren’t a fiduciary, and aren’t giving you the savings you thought. AMPS provides other services, like a reference-based pricing program that they’ve offered for the past 8 years. There are two models: Prospective, which negotiates on the front end but costs more, and retrospective, where negotiation is after the service and there are greater savings. They also do direct contracting. This is where consumerism and competition come into play to benefit both the hospital and employer. AMPS is excited to offer more direct contracts so patients can save money, know their options, get great care, and make informed decisions. The medical bill review process - and the other services that AMPS has to offer - are for any industry. Overpayment in the healthcare industry needs to end, and companies like AMPS are taking strides to make that possible. Here’s a glance at what we discuss in this episode: 00:30 - Introducing John and the issues he sees in the healthcare industry08:40 - The AMPS platform and the problem they solve17:30 - Itemized bill restrictions and the average savings of medical bill review 22:00 - How AMPS integrates with the TPA and makes sure payment is accurate31:00 - The other services that AMPS provides41:00 - Exciting evolutions and the movement towards healthy competition 43:30 - The three fundamental questions to ask your carrier to prove their valueResourcesAMPS Website: https://advancedpricing.com/ John’s Email: jpowers@advancedpricing.comJohn’s Phone Number: (630)631-2525

In this episode, Michael introduces Shane Foss, the founder and CEO of Hooray Health. Hooray Health leverages an Urgent Care and Retail Clinic National Provider Network built for Individual and Group limited medical insurance plans. Shane has over twenty years of tenure as an executive in the medical industry and it was through this work that he became frustrated with the healthcare options in America. When Shane injured his back and needed medical care, he experienced the shortcomings of the healthcare delivery system first-hand when he received a balance bill from an urgent care center. He was able to negotiate down his bill, but the experience left him wondering what other Americans do in similar scenarios. This led to his discovery that many Americans are “functionally uninsured” and there’s no standardization of cost or transparency in the healthcare system. Shane was thus inspired to create a new platform that filled a gap in the market: affordable basic healthcare. Through this inspiration, Hooray Heath was born. Hooray Heath offers a low-cost, practical healthcare plan that is supported by technology and a robust provider network of Urgent Care and Retail Clinics. It is unconventional - which is exactly what Shane wanted. In a country where 75% of the population makes less than $50,000 a year (and many work part-time), Hooray Health offers peace of mind, basic healthcare, no surprise bills, and a fixed price that starts at only $99.The member experience through Hooray Health is simple and centralized through their mobile app, where they offer “telemedicine”, a 24/7 bilingual medical concierge, pharmacy discounts, and more. It’s a fixed indemnity plan but feels like a regular PPO for basic coverage - and is 30% less than other similar plans on average. They offer two plans: a basic plan and a “plus” plan. The basic plan covers a wellness visit, five annual visits to the retail clinic or urgent care, and a $5,000 accident policy. The “plus” option includes everything in the basic plan plus a hospital indemnity buy-up for an additional $60. Hooray Health is easy to deploy and makes joining a seamless experience for both individuals and large corporations. Hooray Health has an exciting road ahead. Next year’s version of the mobile app will be even more integrated and supportive, and they’re working on formulating supplemental alternatives for high-deductible health plans. Hooray Health focuses on a segment of the population that is often overlooked when it comes to healthcare - part-time employees and low-income earners - and makes it so basic coverage is accessible, affordable, and easy for employers and employees alike. Here’s a glance at what we discuss in this episode: 00:30 - Introducing Shane and Hooray Health02:00 - Shane’s previous work in the industry and what inspired Hooray Health05:45 - Why Shane believes we’re “functionally uninsured” as a country08:00 - Employers need to manage their healthcare expenses like any other expense09:30 - How Hooray Health works and who they serve14:30 - The difference between Hooray Health indemnity plans and regular benefit plans 16:00 - The difference between the basic and “plus” plan18:00 - How the Hooray Health concierge service works 20:20 - Information about their medical bill negotiation platform21:30 - Pricing, how they track consumer satisfaction, and their growth since launching 24:45 - Who Hooray Health is for, how it can help reduce turnover, and where they provide coverage29:30 - How Hooray Health connects and communicates with its members 31:00 - What to expect next year and why Hooray Health beats out the competitionResourcesHooray Health Phone Number: 1-866-7HOORAY