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Ep #79: Fortress and Frontier, Part 2: The Move Towards the Frontier – With Robert Graboyes, MSPA, PhD.

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On this episode of Shiftshapers Podcast, we continue our conversation with Dr. Robert Graboyes, Senior Research Fellow at the Mercatus Center at George Mason University, about the economics of health care and why both sides are losing the debate.

Join us as we discuss the reasons why traditional economic principles have worked differently in health care and what is happening (and needs to happen) to move us toward the frontier. Tune in to discover what Bob believes needs to happen in the United States in order to fix our health care system in a way that will help provide better care to more people at a lower cost, year after year. Don’t miss this engaging conclusion of our conversation with one of the nations preeminent healthcare-focused economists!

What You’ll Learn From This Episode:

  • Why most metrics in health care have been focused in demand.
  • How much of the overall problem is due to seeing this as a “demand” rather than a “supply” issue.
  • How innovation in health care currently happens in the U.S. and why that system is broken.
  • The examples of countries that we can learn from to help fix our health care.
  • What we can learn from WWII Pacific operations.

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Ep #78: Fortress and Frontier, Part 1: Why Healthcare Innovation is Lagging Behind Other Industries – With Robert Graboyes, MSPA, PhD.

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In this episode of ShiftShapers Podcast, we are privileged to welcome a leading economist and thought leader in our field, Robert Graboyes. Bob is a Senior Research Fellow at the Mercatus Center at George Mason University where he examines the economics of healthcare. His paper, “Fortress and Frontier in American Health Care” (link below) caught my interest and I invited him to discuss that – and much, much more – on the podcast.

We begin our conversation by exploring why he once referred to health care as an “Economic Oz.” We touch on the implications of the ongoing left-right political struggle over the health care. For good measure, we also delve into the ancient paternalistic tradition of physicians, and how that has contributed to the fortress vs. frontier mentality.

Join us discover why Bob believes that healthcare has been unwilling or unable to take on disruptive innovation like many other industries today and what we can do in order to allow for these beneficial changes to happen. You won’t want to miss the this interesting and informative discussion – or part 2 next week!

What You’ll Learn From This Episode:

  • Why ACA is “an unworkable vision with multiple applause lines.”
  • What Robert means by “Fortress and Frontier.”
  • Why healthcare innovation has lagged behind other industries.
  • How much of the overall problem is due to seeing this as a “demand” rather than a “supply” issue.
  • When and how did we go from insurance to prepaid health care.
  • What we can learn from WWII Pacific operations.

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Ep #77: Free Market Medicine is Disrupting and Transforming Markets – With Charlie Sauer

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In earlier episodes (see links below) we have spoken with physicians who are taking a very different, and more free-market approach to pricing health care. Their numbers are growing rapidly and while some may think that “free market medicine” is an oxymoron or an impossible dream, a new and growing association is beginning to prove otherwise.

On this episode of ShiftShapers podcast, we’re excited to welcome Charlie Sauer, co-founder and the executive director of the Free Market Medical Association. Their organization is dedicated to promoting transparency and forwarding the ideals and practice of medicine without the intervention of government and other third parties.

We invited Charlie to talk about the transformative nature of free market medicine. We asked Charlie how it can be possible to have free market in medicine in an environment where the government pays more than 50% of health care spend. We discuss the issue of whether consumers would be better off if artificial discount arrangements and multiple third parties were removed from the health care pricing landscape and why Charlie believes that our country is headed in that direction.

What You’ll Learn From This Episode:

  • Whether the health care in the United States is an economic Oz.
  • How you can promote free market solutions with the government paying more than 50% of health care expenditures.
  • How we can get out of this cycle.
  • Whether the ACA complicated the problem.
  • The tools do consumers need.

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Ep #76: What You Need To Know About Defined Contribution Plans – With Bill Hill

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From fully-insured to self-insured, a great deal of focus is on funding strategies rather than products. In previous episodes of ShiftShapers podcast, we’ve discussed everything from minimum premium to captive arrangements. In this episode Bill Hill, president and CEO of Visor Benefits, helps us take a deep dive into the defined contribution plans and some of the novel ways to deploy them with your prospects and clients.

We invited Bill to share his unique journey and some interesting things he has learned along the way about defined contribution and what role it plays in his practice today.  We explore the changes ACA has made in the design and deployment of this arrangement. We also talk about how geographic and specific market variations and needs influence plan offerings. Learn some of the insider tips you need to be aware of to best serve your clients when discussing defined contribution plans with employers.

What You’ll Learn From This Episode:

  • The regional differences of two companies Bill worked with.
  • How Alaska factored in.
  • Whether smaller groups should eliminate group coverage.
  • Whether advisors should lead employer conversations with plan design or concept.
  • Whether these approaches work in self-insured plans.

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Ep #75: Renewed Interest in On-Site and Near-Site Clinics – With Karen Hjerleid

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Increases in personal responsibility, a need to control employer costs and a desire to improve the health of employee populations are renewing an interest in the area of on-site and near-site clinics. Karen Hjerleid, the Vice-President of National Business Development at Paladina Health shares her knowledge of the area and offers insight into an old concept that may make sense for an ever-increasing number of employers.

Karen joins us to talk about how the ACA has increased populations seeking care from smaller networks and overburdened providers. Those characteristics can often result in employees not receiving care when they need it.  Coupled with deferred care due to ever-larger out of pocket amounts, Karen believes a new model of the old clinic structure can offer answers to these and other system-related problems.

We explore the different types of arrangements and how advisors can best position them with their prospects and clients. We ask Karen about the reasons that traditional carriers have not warmed to this option are beginning to come around now that the interexchange of data has become more robust and real-time.

What You’ll Learn From This Episode:

  • The perverse incentives in the system.
  • What drives the interest in employer-sponsored clinics.
  • Whether the group size matters.
  • What the medical home is and why it is important.
  • Whether there is a robust data exchange between clinics and carriers within those clinics.

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Ep #74: New Opportunities in Previously Uninsured Group Markets – With Bob Gardner

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More so today than at any time in the past, benefit advisors are looking for new markets to serve. In this episode, we discuss some non-traditional markets that may be new to many of our listeners and we discuss the techniques that resonate in those markets. There’s no better person to talk about this topic than our guest, Bob Gardner, the National  Business Development Coordinator of Freedom Care Benefits.

We invited Bob to talk about the new opportunities and imperatives in previously uninsured group markets and what advisors need to know to be able to capitalize on those opportunities. In this conversation, we define these traditionally uninsured market segments and discuss the reasons why advisors should consider serving them. Don’t miss this important episode that will surely open your eyes to some new and interesting possibilities.

What You’ll Learn From This Episode:

  • What these traditionally uninsured markets are.
  • What has made them a new priority.
  • Interesting ways to solve problems while mitigating costs.
  • Whether traditional group carriers participate in these markets.
  • What the advisor/client conversation looks like.

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Ep #73: Using Reinsurance for Pharmacy Costs to Mitigate Overall Health Spend – With Crystal Williams

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In the post-ACA environment we have seen intensely increased interest in self insured financing arrangements. Some elements of self-insurance are now making their way out as stand-alone components, and are even being applied to fully-insured plans. Our guest and subject matter expert, Crystal Williams, President of RxReins joins us to discuss reinsuring one of the biggest cost drivers in any plan: pharmacy.

In this episode of The ShiftShapers podcast, Crystal explains the basics of stop loss coverage. We explore strategies and tactics that advisors can use when discussing this cost driver with prospects and clients. Crystal also gives us the carrier’s perspective on this unique strategy as applied to fully-insured plans. This is a novel conversation that will help you to differentiate yourself and deliver value-added intelligence for your clients.

What You’ll Learn From This Episode:

  • The basics of stop loss coverage.
  • Whether it is unusual to apply stop loss to pharma only.
  • How this can work with fully insured plans.
  • The impact of this type of arrangement.
  • What to benefit advisors need to know to discuss this with their prospects and clients.

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Ep #72: Best Practices and Innovative Agency Techniques – With Emily Bremer

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In today’s environment, the average age of benefit advisors and agency owners is increasing, but there are some younger people coming into the insurance business and they are bringing innovation and new best practices to the table. Emily Bremer, founder at Bremer Conley Insurance Brokers & Consultants is one of those advisors, and she joins us to discuss some of the things her agency is doing.

We discuss some of the issues with the traditional agency systems, as well as compensation compression and what Emily and other new independent benefits advisors are doing to solve those problems. While these newer advisors are “fiercely independent”, you may be surprised at how some of them are joining together to create a cooperative that maximizes resources and eliminates duplication and waste – all of which will increase profitability.

What You’ll Learn From This Episode:

  • Emily’s journey into the insurance business.
  • The problem with traditional agency compensation systems.
  • How and why she is working on forming a cooperative.
  • The new best practices she is developing.

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Ep #71: What You Need to Know About Mergers and Acquisitions – With Brett Rosen

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Merger and acquisition activity has increased dramatically. Fueled in part by new levels of ACA-induced complexity, some benefits advisors are selling their practices and leaving the business. Others are taking a different view and finding opportunities to join forces with other practices to create new practice models that deliver incredible value to their clients.

In this episode of The ShiftShapers podcast, we interview Brett Rosen, Executive Vice President of Mergers & Acquisitions at Digital Benefit Advisors. We begin our wide-ranging interview by exploring the most important things driving the M&A wave. Brett offers his expertise and opinions on the advantages some firms find by becoming a part of a larger organization.

Finally, we touch on the steps that agencies and their owners can take today if they think merging or being acquired might be a future strategy. We also discuss the other side of the equation: what to look for if you want to purchase another entity.

Complexity is going to continue to deepen as our industry undergoes transformative change. Learn how and why this strategy might help you to survive and thrive.

What You’ll Learn From This Episode:

  • The drivers in the recent uptick in M&A activity.
  • How PPACA has impacted the process.
  • The advantages to merging.
  • The steps agencies can take today if they think a merger or acquisition might make sense in the future.
  • What to look for if you want to be the a purchaser.

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Ep #70: Voluntary Benefits, Part 2: The Large Group Market – With Frank Doherty and Brian Jund

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On this second part of our look at the voluntary benefits, we invited Frank Doherty and Brian Jund, Co-founders of National Benefit Partners, to the ShiftShapers podcast to discuss their particular area of specialization – the large group market.

Join us to discover how the large groups have used voluntary benefits in the past and how new benefits are coming to market. We also explore how PPACA has accelerated the interest in voluntary products as a key part of an employer’s overall benefit strategy.

Frank and Brian discuss some of the innovative, non-traditional, solution-based offerings in the VB space that have come to the forefront in the recent years. We also explore the hurdles consultants have to overcome when having effective conversations with clients and prospects and the key role technology plays in the implementation process.

Don’t miss this in-depth look at the similarities as well as the key differences in voluntary benefits offerings, technology and marketing in the large group segment.

What You’ll Learn From This Episode:

  • The large group voluntary benefit offerings of the past.
  • Whether the large employers have been at the forefront of voluntary benefits.
  • How PPACA has impacted the interest in voluntary benefits.
  • Some of the newer, innovative benefits being offered.
  • The role of technology in successful large group voluntary sales and implementations.
  • Whether the large group compensation is structured differently than small group.

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